OKLAHOMA LEGAL AND OPERATING REQUIREMENTS

Licensing and Certification:

A certification (license) from the Okla. Dept. of Mental Health and Substance Abuse Services (ODMHSAS) is mandated by Oklahoma Statute at Title 43A.

Title 43A also mandates that Community Residential Mental Health providers be certified, if they contract with the ODMHSAS.

Additionally, pursuant to Oklahoma Health Care Authority (OHCA) rules, any providers of Outpatient Mental Health services for Medicaid reimbursement may be certified by the ODMHSAS in lieu of having a national accreditation. Please note that during the minimum six-month phase for the Permit for Temporary Operation, providers cannot bill OHCA for services rendered.

Also note that the law provides for exemption from the certification process for licensed physicians, psychologists, social workers, certified alcohol and drug abuse counselors, and individual members of the clergy. This exemption applies only to professional individuals in their private practice, and not to any treatment facilities operated by such persons.  

Operating Requirements:

  1. Mental health facilities in Oklahoma need to use the Screening, Brief Intervention, and Referral to Treatment (SBIRT), which is an evidence-based, public health approach that aims to identify, reduce, and prevent problematic use, abuse, and dependence on alcohol and drugs and symptoms of depression and suicidality.  
  1. Mental health facilities should also work with the Oklahoma Department of Mental Health and Substance Abuse Services to get best practices, evidence-based guidelines and technical assistance for the safe and responsible treatment of chronic pain, including prescriptions for opioids when indicated, with the ultimate goals of patient safety and functional improvement.
  1. Mental health facilities should also work with the Oklahoma Systems of Care, which is a state-wide collaborative network involving members of local communities, organizations, agencies, facilities, centers and groups that serve the needs of children, youth, and young adults.

Regulations include:  

  1. Mental Health Law

This Act regulates the humane care and treatment of persons who are mentally ill.

  1. Mental Health Parity and Addiction Equity Act

This Act requires that facilities offering mental health and substance use disorder (MH/SUD) services be covered by health insurance companies.

  1. Alzheimer’s Disease Special Care Disclosure Act.

This act regulates the care provided to people with Alzheimer’s disease.

  1.   Alzheimer’s Disease Special Care Disclosure Rules

These Rules govern the disclosure of information on special care provided to persons with Alzheimer’s disease.

NEVADA LEGAL AND OPERATING REQUIREMENTS

Licensing and Certification:

Nevada mental health counselors are licensed as Clinical Professional Counselors. The LCPC credential is granted to professionals who have met education and examination requirements that are specific to the mental health counseling field. A counseling graduate who has met educational requirements and passed background screening is eligible for licensing at the intern level.

Further, the state of Nevada contains different licensing requirements for a variety of services, which may be offered in your mental health care facility. Because of the volume of the requirements I have provided links to every category, which will be easy for your perusal, as follows:

  1. For facilities offering alcohol and drug treatment, please see https://dpbh.nv.gov/uploadedFiles/dpbhnvgov/content/Reg/HealthFacilities/Docs/Checklists/ADA_Checklist.pdf .
  1. For facilities offering care for persons with developmental disabilities, please see https://dpbh.nv.gov/uploadedFiles/dpbhnvgov/content/Reg/HealthFacilities/Docs/Checklists/IMR_Checklist.pdf 
  1. For facilities offering narcotic treatment and/or care, please see https://dpbh.nv.gov/uploadedFiles/dpbhnvgov/content/Reg/HealthFacilities/Docs/Checklists/NTC_Checklist.pdf 
  1. For any skilled nursing facility, please see https://dpbh.nv.gov/uploadedFiles/dpbhnvgov/content/Reg/HealthFacilities/Docs/Checklists/SNF_Checklist.pdf 

Operating Requirements:

Any licensed mental health service provider can serve victims who are approved applicants with the Victims of Crime Program (VOCP). Once an eligible victim goes to a licensed mental health provider for treatment and the provider submits a bill to the VOCP, the provider is listed in our system as a provider of services. To speed processing, the service provider should include verification of licensure and a completed IRS Form W-9 with the first bill submitted to the VOCP.

Regulations include:  

  1. Nevada Administrative Code (NAC) 449 et seq

This law contains regulations of the State Board of Health regarding functional programs for rehabilitation facilities and/or hospitals.

  1. Nevada Revised Statute (NRS) Chapter 641A et seq

This law sets minimum standards for licensing of Marriage and Family Therapists (MFTs) and Clinical Professional Counselors (CPC) and to oversee the ethical conduct of MFT & CPC licensees in the State of Nevada.

FLORIDA LEGAL AND OPERATING REQUIREMENTS

Licensing and Certification:

To be licensed as a mental health residential treatment facility (RSF) an applicant must maintain an environment that provides care, support, assistance and limited supervision in daily living. The facility must also sustain a 60 day average or greater length of stay of residents. You should also note that if your facility primarily offers clinical residential services, either during an urgent care episode or during the 90 days following such an episode your facility shall not be licensable.

Every RTF must be licensed annually by AHCA unless specifically excluded from licensure under the provisions of subsection 394.875(5), F.S.

You should also note that facility buildings that are separated from one another in which a similar level of residential care and treatment is provided F.A.C., may be licensed as one facility.

Applicants for an original license are also required to submit a completed AHCA Form, 3180-5003 Feb. 96, “Crisis Stabilization Unit, Short-Term Residential Treatment Facility and Residential Treatment Facility Licensure Application” effective February, 1996, which is incorporated by reference and provided by AHCA. The following supplemental information must be attached to the application:

  1. Program narrative;
  2. Table of Organization, including all management levels between the RTF and the governing board;
  3. Resume of the RTF manager;
  4. Fiscal information;
  5. Proof of liability insurance coverage;
  6. Copy of current fire safety inspection certificate;
  7. Copy of current health inspection certificate;
  8. Proof of current JCAHO accreditation, if applicable; and
  9. For Level I and II facilities, a signed statement from the appropriate government official that the facility has met applicable local zoning requirements.

A newly developing facility will be provided a 90-day probationary license after the completed application has been verified for compliance with Rule 65E-4.016, F.A.C.

An applicant for renewal of a license shall apply to AHCA no later than 90 days before expiration of the current license.

Applicants for renewal of a license to operate a facility shall submit an application that meets the requirements of paragraph 65E-4.016(3)(a), F.A.C.

License Fee. An annual non-refundable license fee shall be submitted with the application for licensure. The fee shall be reasonably calculated annually to cover the cost of regulation. The formula for calculating this fee is the cost of Office of Health Facility Regulation positions for the process of surveying crisis stabilization units, short-term residential treatment facilities, and residential treatment facilities for licensure divided by the total number of crisis stabilization units, short-term residential treatment facilities, and residential treatment facility beds times the number of beds in the facility applying for licensure. The license, AHCA Form 3180-5001 Feb. 96, effective February, 1996, shall be displayed in a conspicuous location inside the facility.

Operating Requirements:

The operating requirements include:

  1. Level 1A facilities:

Level IA facilities must maintain a minimum of 1-10 staff to resident ratio with never less than 2 staff on the premises at all times. There must be 24 hours per day, 7 days per week nursing supervision, provided minimally by a licensed practical nurse under the direction of an on-call licensed physician or registered nurse.

A Level IA facility must provide a structured group treatment setting with 24 hours per day, 7 days per week supervision for residents who have major skill deficits in activities of daily living and independent living, and are in need of intensive staff supervision, support and assistance. Nursing services are provided on this level but are limited to medication administration, monitoring vital signs, first aid, and individual assistance with ambulation, bathing, dressing, eating and grooming.

  • Level 1B facilities:

Level IB facilities must meet all Level IA criteria with the exception of fire safety requirements. Level IB fire safety requirements are specified in sub-subparagraph 65E-4.016(17)(b) 2.a., F.A.C.

  • Level II facilities

A Level II facility must provide a structured group treatment setting with 24 hour per day, 7 days per week supervision for five or more residents who range from those who have significant deficits in independent living skills and need extensive supervision, support and assistance to those who have achieved a limited capacity for independent living, but who require frequent supervision, support and assistance.

Level II facilities must maintain a minimum of 1-15 staff to resident ratio with never less than one staff on the premises when residents are present during normal waking hours. During normal sleeping hours, a minimum of 1-22 staff to resident ratio is required. The facility must have procedures to mobilize additional staff 24 hours daily in the event of emergency need.

  • Level III

A Level III facility must have collocated apartment units with an apartment or office for staff who provide on-site assistance 24 hours per day, 7 days per week. The facility may be comprised of a block of apartments within a large apartment complex. The residents served in this facility have a moderate capacity for independent living.

Level III facilities must maintain a minimum 1-20 staff to resident ratio with never less than one staff on the premises when residents are present during normal waking hours. During normal sleeping hours, a minimum of 1-40 staff to resident ratio is required. The facility must have procedures to mobilize additional staff 24 hours daily in the event of emergency need.

  • Level IV

A Level IV facility provides a semi-independent, minimally structured group setting for 4 or more residents who have attained most of the skills required for independent living and require minimal staff support.

Level IV facilities may have less than 24 hours per day, 7 days per week on-premises supervision; however, on-call staff must be available at all times. Staff shall have a minimum of weekly on-premises contact with residents.

  • Level V

A Level V facility must provide a semi-independent, minimally structured apartment setting for 1 to 4 residents who have attained adequate independent living skills and require minimal staff support. The apartments in this setting are owned or leased by the service provider and rented to residents. All apartments on this level that are operated by a service provider, regardless of location, shall be considered the premises of the facility.

Level V facilities may have less than 24 hours per day, 7 days per week on-premises staff; however, on-call staff must be available at all times. Staff shall have a minimum of weekly on-premises contact with residents

Regulations include:  

  1. Fla. Admin. Code Ann. R. 65E-4.016

This Act regulates the licensure and operation of Mental Health Residential Treatment Facilities.

FLORIDA LEGAL AND OPERATING REQUIREMENTS

Licensing and Certification & Operating Requirements:

For licensing to be effected, the quality of the services offered by the applying facility should be determined by professional standards.

The facility applying for licensing must be a growing, developing, social organization with different stages of differentiation and versatility dependent upon the specific local internal and community forces acting at a given point in time.

The applying facility shall acknowledge the dignity and protect the rights of all persons within its authority to direct or regulate both personnel and clientele.

The applying facility shall have an ethical and competent staff, and the recruitment practices shall provide measures to insure the hiring of personnel with these characteristics.

Services of the applying facilities must be offered to the mentally ill, the mentally retarded, persons under specific or unusual stress, or handicapped persons.

The applying facility shall make provisions to cooperate with other community agencies within the scope of its resources and the skills of its personnel, and within its capacities to respond to the community needs.

The applying facility shall keep accurate, current, and adequate client and administrative records, and shall submit reports derived from such records as required by the licensing facility to carry out these licensing procedures.

The applying facility shall have written policies and procedures covering operation of the facility, including a written policy on how the facility is related to the statewide mental health planning effort.

The applying facility shall provide a physical plant which is a safe and wholesome environment fit to enhance the program.

The applying facility shall plan the program and physical plant to be accessible to clientele in point of view of time, location, and transportation. (Authorized by and implementing K.S.A. 75-

3307b; effective, E-70-16, Feb. 13, 1970; effective Jan. 1, 1971; amended Jan. 1, 1974; amended

May 1, 1975; amended Feb. 15, 1977; amended May 1, 1979; amended Oct. 28, 1991.)

Regulations include:  

  1. Kansas Administrative Regulations § 30-22 et seq

This law regulates the licensing of mental health services providers.

  1. K.S.A. 75-3307b 

This law regulates the hospitalization or treatment of mentally ill persons; rules and regulations; licensing; standards; continuation of licensure of certain entities; injunction powers; inspections in that regard.

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