(1) Intensive level therapeutic youth group homes are subject to the staffing/treatment requirements of this rule in addition to the applicable staffing requirements of ARM 37.97.524.

(2) Intensive level therapeutic youth group home providers must meet additional minimum staffing requirements to provide a therapeutic environment and treatment interventions identified in the child's individual treatment plan. For the purpose of licensing:

(a) An intensive group home with four or fewer children must have a child to staff ratio of no more than 2:1 each day for a 15-hour period beginning at, or between 7 a.m. and 7:30 a.m., (or beginning at or between some other reasonable morning half hour which is approximately 15 hours prior to the bedtime of the children) , when children are in care. Child to awake staff ratio must be no more than 4:1 each night for a nine-hour period beginning no earlier than 15 hours from the time that daytime staffing is initiated, when children are in care.

(b) An intensive group home with five or six children must have a child to staff ratio of no more than 3:1 each day for a 15-hour period beginning at, or between, 7 a.m. and 7:30 a.m., (or beginning at or between some other reasonable morning half hour which is approximately 15 hours prior to the bedtime of the children) , when children are in care. Child to awake staff ratio must be no more than 6:1 each night for a nine-hour period beginning no earlier than 15 hours from the time that daytime staffing is initiated, when children are in care.

(c) An intensive group home with seven or eight children must have a child to staff ratio of no more than 8:3 each day for a 15-hour period beginning at, or between 7 a.m. and 7:30 a.m., (or beginning at or between some other reasonable morning half hour which is approximately 15 hours prior to the bedtime of the children) , when children are in care. Child to awake staff ratio must be no more than 8:1.5 each night for a nine-hour period beginning no earlier than 15 hours from the time that daytime staffing is initiated, when children are in care.

(d) Each intensive therapeutic youth group home shall have one or more program managers with responsibility as follows:

(i) in a four to six bed facility, one full-time program manager for up to six children in care. Under this subsection, a full-time program manager means a program manager working a minimum of 40 hours per week; and

(ii) in a seven or eight bed facility, 1.5 full-time program managers for up to eight children in care. Under this subsection, 1.5 full-time program managers means program managers working a combined minimum of 60 hours per week.

(e) Each LCS shall be responsible for no more than 12 children.

(f) There must be adequate staff to allow the LCS, the program manager or professional support staff who provide services under the supervision of a master's or higher level clinician to implement individualized treatment plans developed by the treatment team. Documentation of individual, group and family therapy must be completed for each session and be included in quarterly treatment summaries. Treatment plans shall include, but are not limited to:

(i) specific treatment plan objectives and interventions which are carried out in the treatment environment and documented by daily charting;

(ii) three group treatment sessions per child;

(iii) two individual treatment sessions per child;

(iv) two treatment team meetings; and

(v) family therapy when appropriate and medically necessary.