441—185.10 (234) Provider certification standards. Certification is the process by which the department shall ensure that providers meet the requirements for provision of rehabilitative treatment services.
Each provider of rehabilitative treatment services shall meet the following criteria for certification:
	 185.10(1) Staff qualifications. The provider of the following services shall document the credentials and experience of the individuals providing services under the rehabilitative treatment program.
	  a.   	 Therapy and counseling services, psychosocial evaluation and behavioral management services for children in therapeutic foster care shall be provided by staff who meet one of the following minimum education and experience or professional licensing criteria:
	 (1) 	 Graduation from an accredited four-year college, institute or university and the equivalent of three years of full-time experience in social work or experience in the delivery of human services in a public or private agency. These individuals shall have been employed prior to September 1, 1993, by an agency with interim certification under rule 441—185.9(234) published on January 5, 1994, and subrule 185.11(1) published on January 5, 1994, or be an individual with interim certification under rule 441—185.9(234) published on January 5, 1994, and subrule 185.11(1) published on January 5, 1994. Persons meeting this criterion shall not be qualified to provide therapy and counseling, psychosocial evaluation, or behavioral management services for children in therapeutic foster care if they change place of employment.
	 (2) 	 Graduation from an accredited four-year college, institute or university with a bachelor’s degree in social work from a program accredited by the council on social work education.
	 (3) 	 Graduation from an accredited four-year college, institute or university with a bachelor’s degree in a human service field related to social work and the equivalent of two years of full-time experience in social work or experience in the delivery of human services in a public or private agency.
	 (4) 	 A master’s degree in social work or related human service field from an accredited college, institute or university.
	 (5) 	 Graduate education in the social work or related human services field from an accredited college, institute or university may be substituted for up to a maximum of 30 semester hours for one year of the required experience.
	 (6) 	 Graduation from an accredited four-year college, institute or university with a bachelor’s degree in social work or related human service field. These individuals shall have had continuous employment in the same agency since August 31, 1993, and the agency shall have received interim certification under rule 441—185.9(234) published on January 5, 1994, and subrule 185.11(1) published on January 5, 1994, or be an individual who received interim certification under rule 441—185.9(234) published on January 5, 1994, and subrule 185.11(1) published on January 5, 1994. Persons meeting this criterion shall not be qualified to provide therapy and counseling, psychosocial evaluation, or behavioral management services for children in therapeutic foster care if they change place of employment before they have two years of experience.
	 (7) 	 Licensed in Iowa as an independent social worker, master social worker, psychologist, psychiatric mental health nurse practitioner, marital and family therapist or mental health counselor.
	  b.   	 Skill development services shall be provided by staff who meet one of the following minimum education and experience or professional licensing criteria:
	 (1) 	 Graduation from an accredited four-year college, institute or university with a bachelor’s degree in social work, or related human service field.
	 (2) 	 Graduation from an accredited four-year college, institute or university and the equivalent of one year of full-time experience in social work or in the delivery of human services in a public or private agency. Individuals with this level of education who provided skill development services prior to September 1, 1993, can provide skill development services without the one year of experience, if they have maintained continuous employment since August 31, 1993, with an agency that received interim certification under rule 441—185.9(234) published on January 5, 1994, and subrule 185.11(1) published on January 5, 1994, or if they had a family-centered contract with the department prior to September 1, 1993, and were granted interim certification under rule 441—185.9(234) published on January 5, 1994, and subrule 185.11(1) published on January 5, 1994. Persons meeting this criterion shall not be qualified to provide skill development if they change place of employment before they have one year of experience.
	 (3) 	 Graduate education in social work, or a related human service field from an accredited college, institute or university may be substituted for up to a maximum of 30 semester hours for one year of required experience.
	 (4) 	 A high school diploma or GED and the equivalent of one year of full-time experience in social work, or experience in the delivery of human services in a public or private agency. Individuals with this level of education who provided skill development services prior to September 1, 1993, can provide skill development services without the one year of experience if they have maintained continuous employment since August 31, 1993, with an agency that received interim certification under rule 441—185.9(234) published on January 5, 1994, and subrule 185.11(1) published on January 5, 1994, or had a family-centered contract with the department prior to September 1, 1993, and received interim certification under rule 441—185.9(234) published on January 5, 1994, and subrule 185.11(1) published on January 5, 1994. Persons meeting this criterion shall not be qualified to provide skill development if they change place of employment before they have one year of experience.
	 (5) 	 Graduation from an accredited community college with a two-year associate degree in a related human service field or an associate of science career option degree, or graduation from a certified two-year nursing program.
	 (6) 	 Sixty college credit hours toward a degree in social work or a related human service field from an accredited four-year college, institute or university may be substituted for the one year of required experience when at least 12 of the 60 hours are in the field of social work or a related human service field.
	 (7) 	 Licensed in Iowa as an independent social worker, master social worker, bachelor social worker, psychologist, psychiatric mental health nurse practitioner, marital and family therapist or mental health counselor.
	 185.10(2) Staffing requirements. The agency or individual shall certify that they meet the staffing ratios set forth in this chapter. The agency or individual shall maintain records to demonstrate that qualified staff responsible for direct provision or supervision of rehabilitative treatment services are present in sufficient number to meet the requirements.
	 185.10(3) Supervision requirements. Provider staff who provide skill development services and who do not meet the qualifications for provision of therapy and counseling pursuant to 185.10(1)“a” shall receive supervision by an employee or consultant with those qualifications. Supervision shall occur on a face-to-face basis, and may be conducted on an individual or group basis. The provider shall document the date of supervision meetings, who was present, and the general focus of discussion. Supervision requirements may be waived for staff who are absent due to vacation or sick leave.
	  a.   	 For individuals who meet the qualifications in 185.10(1)“b”(4) and who work full-time, supervision shall occur no less than once per week. For individuals who meet the qualifications in 185.10(1)“b”(4) and who work part-time, supervision shall occur no less than once every two weeks.
	  b.   	 For individuals who meet the qualifications in 185.10(1)“b”(1), 185.10(1)“b”(2), 185.10(1)“b”(3), 185.10(1)“b”(5), or 185.10(1)“b”(6) and who work full-time, supervision shall occur at least two times per month. For individuals who meet the qualifications in 185.10(1)“b”(1), 185.10(1)“b”(2), 185.10(1)“b”(3), 185.10(1)“b”(5), or 185.10(1)“b”(6) and who work part-time, supervision shall occur no less than once a month.
	 185.10(4) Treatment plan development. The provider shall develop a treatment plan for each individual and family receiving treatment services except for the psychosocial evaluation services core. Treatment plans shall meet the following conditions:
	  a.   	 The treatment plan shall be developed in collaboration with the referral worker, child, family, and, if applicable, the foster parents unless the treatment plan contains documentation for the treatment rationale for the lack of involvement of one of these parties. The provider shall document the dates and content of the collaboration on the treatment plan. The provider shall provide a copy of the treatment plan to the family and the referral worker, unless otherwise ordered by the court.
	  b.   	 Initial treatment plans shall be developed after services have been authorized and within 30 calendar days of initiating services, except in the case of the family preservation program the treatment plan shall be developed within 10 calendar days of initiating services.
	  c.   	 The treatment plan shall identify the following:
	 (1) 	 Strengths and needs of the child and family.
	 (2) 	 Goals, which are statements of outcomes to be achieved to meet the medical-behavioral health care needs of the child identified on Form 470-3055, Referral of Client for Rehabilitative Treatment and Supportive Services.
	 (3) 	 Objectives, which are specific, measurable, and time-limited statements of indicators, levels of competence or accomplishments of the child which are necessary for progress toward each goal.
	 (4) 	 Specific treatment service activities to be provided to achieve the objectives.
	 (5) 	 Designation of the persons responsible for providing the services. When providing restorative living and social skill development in a group care setting, designation may be by job title.
	 (6) 	 Date of service initiation and date of treatment plan development.
	 185.10(5) Treatment plan review and revision. Individuals qualified to provide therapy and counseling services pursuant to paragraph 185.10(1)“a” shall review the services identified in the treatment plan to ensure that the services are necessary, appropriate, and consistent with the identified medical-behavioral health care needs of the child listed on Form 470-3055, Referral of Client for Rehabilitative Treatment and Supportive Services.
	  a.   	 All treatment plans shall be reviewed as follows:
	 (1) 	 Ninety calendar days from the initiation of services and every 90 calendar days thereafter for the duration of the services.
	 (2) 	 When any changes are made by the review organization to the identified medical-behavioral health care need of the child listed on Form 470-3055, Referral of Client for Rehabilitative Treatment and Supportive Services.
	 (3) 	 Five working days after a skill development qualified staff has developed an initial or revised treatment plan for skill development services.
	  b.   	 All treatment plans shall be revised when any of the following occur:
	 (1) 	 Treatment goals or objectives have been achieved.
	 (2) 	 Progress is not being made.
	 (3) 	 Changes have occurred in the identified medical-behavioral treatment needs of the child listed on Form 470-3055, Referral of Client for Rehabilitative Treatment and Supportive Services.
	 (4) 	 The treatment plan is not consistent with the identified medical-behavioral treatment needs of the child listed on Form 470-3055, Referral of Client for Rehabilitative Treatment and Supportive Services.
	  c.   	 The treatment plan shall be signed and dated by qualified staff after each review and revision. The treatment plan shall be revised in collaboration with the child, family, referral worker and, if applicable, the foster parents. The revision of the treatment plan must reflect the services authorized and the identified medical-behavioral health care needs of the child. The revised treatment plan must meet the requirements for a treatment plan in paragraph 185.10(4)“c.” The provider shall provide a copy of all the revised treatment plans to the family and referral worker, unless otherwise ordered by the court.
	 185.10(6) Treatment records. The agency or individual shall maintain confidential individual records for each individual or family receiving treatment services. The record shall include the following:
	  a.   	 Case permanency plan as supplied by the referral worker.
	  b.   	 Documentation of billed services. Documentation shall include: the date and amount of time services were delivered except when delivering restorative living and social skill development services in a group care setting only the date and shift hours shall be identified, who rendered the services, the setting in which the services were rendered, the specific services rendered and the relationship of the services to the services described in the treatment plan, and updates describing the client’s progress. For the family preservation program this documentation shall be provided every ten days on Form 470-2413, Family Preservation Service Report.
	  c.   	 All initial and revised treatment plans developed by the agency.
	  d.   	 Correspondence with the referral worker regarding change in the case permanency plan or treatment plan or requests for authorization for additional services and any relevant evaluation activities including procedures and tests completed.
	  e.   	 Discharge summary which identifies the reason for discharge, date of discharge, the recommended action or referrals upon discharge, treatment progress, and outcomes.
	  f.   	 Progress reports 90 calendar days after initiating services and every 90 calendar days thereafter which summarize progress and problems in achieving the goals and objectives of the treatment plan. The progress report shall be written in conjunction with the treatment plan review and shall be completed no more than 15 calendar days before the report is due or 15 calendar days after the report is due. This report may serve as either a discharge summary or a recommendation for continued rehabilitative treatment service. If the report serves as a discharge summary, the report shall meet the requirements for a discharge summary. The provider shall provide a copy of all progress reports to the family and referral worker, unless otherwise ordered by the court.
	  g.   	 For psychosocial evaluation services, evaluation reports.
	  h.   	 Additional reports if requested by the referral worker.
	  i.   	 Form 470-3055, Referral of Client for Rehabilitative Treatment and Supportive Services.
	 185.10(7) Staff training. An agency shall provide orientation training on the agency’s purpose, policies and procedures within one month of hire and 24 hours of training in the first year of employment for all employed and contracted treatment staff. The 24 hours of training shall include: training on children and families’ mental health service topics, and two hours of training related to the identification and reporting of child abuse for all employed or contracted treatment staff in accordance with Iowa Code section 232.69. An agency shall provide 12 hours of training per year after the first year of employment for all employed and contracted treatment staff. The 12 hours of training shall include: training on children and families’ mental health service topics and child abuse training every five years in accordance with Iowa Code section 232.69. The training formats that shall qualify as training are as follows: in-service training, seminars, conferences, workshops, institutes, visiting other facilities, and meeting with consultants.
The training provided shall be documented. The documentation shall include the training topic, format, date and number of hours.
	 185.10(8) Other conditions of certification. To receive full certification providers shall meet the following conditions if applicable:
	  a.   	 Rescinded IAB 4/11/07, effective 7/1/07.
	  b.   	 Rescinded IAB 4/11/07, effective 7/1/07.
	  c.   	 Rescinded IAB 4/11/07, effective 7/1/07.
	  d.   	 Providers of family-centered psychosocial evaluation shall prepare within 14 calendar days following termination of services evaluation reports which summarize the results and recommendations of the psychosocial evaluation services provided to a child and family. The provider shall provide a copy of this evaluation report to the family and referral worker, unless otherwise ordered by the court. The evaluation report shall contain the following information:
	 (1) 	 Sources of information and methods of assessing and observing the child and family used to complete the evaluation.
	 (2) 	 Answers to any specific questions from the referral worker.
	 (3) 	 Child and family safety and risk factors.
	 (4) 	 Child and family strengths, including how these strengths may be used in further service delivery.
	 (5) 	 Recommendations for further services including suggested goals, objectives, and methods of service delivery.
	  e.   	 Rescinded IAB 4/11/07, effective 7/1/07.