These rules establish licensing procedures and operating requirements for private alternative adolescent residential programs in Montana, covering application and renewal processes, fee schedules, admissions and discharge procedures, case planning, participant rights and grievances, background check requirements for staff and associated persons, abuse/neglect reporting, serious incident reporting, and physical environment standards. Operators must submit written policies and procedures for department approval, maintain required staffing ratios, comply with background check and reporting mandates, and meet specific physical plant standards. Programs that market chemical dependency treatment services must obtain a separate license under Title 50. The chapter does not govern clinical behavioral health treatment facilities.
View official source37.99.101 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: PURPOSE (1) These rules establish licensing procedures and licensing requirements for private alternative adolescent residential or outdoor programs. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-801 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.102 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: DEFINITIONS (1) "Adolescent" means any person between the ages of 10 and 19 years who is placed in a program by a parent/legal guardian. (a) Upon admission to the program, the adolescent is considered a program participant. (b) The adolescent may remain as a program participant up to the age of 20 if they are enrolled in an accredited secondary school. (2) "Case plan" means a specific plan for providing care, treatment, and services of any kind to a specific program participant. (3) "Chemical restraint" means the use of a drug or medication that is used to control behavior or restrict the program participant's freedom of movement, and which is not a standard treatment for the program participant's medical or psychiatric condition. (4) "Correspondence search" means reading a program participant's mail or inspecting the contents of a package. (5) "Department" means the Department of Public Health and Human Services. (6) "Direct care staff" or "staff" means program personnel who directly participate in the care, supervision, and guidance of the program participants. (7) "Discharge plan" means a realistic plan developed to transition the program participant home or to a less restrictive and appropriate placement with specific services identified and available. (8) "Licensed addiction counselor" means a person licensed under Title 37, chapter 35, MCA. (9) "Licensed health care professional" means a licensed physician, physician assistant, or advanced practice registered nurse who is practicing within the scope of the license issued by the Department of Labor and Industry. (10) "Licensure bureau" means the Office of Inspector General Licensure Bureau. (11) "Mechanical restraint" means the use of devices as a means of restricting a person's freedom of movement. (12) "Mental health professional" means a person licensed pursuant to Title 37, chapters 22, 23, or 37, MCA, as a clinical professional, social worker, or marriage and family therapist. (13) "Near miss" means an unplanned, unforeseen, or potentially dangerous situation where safety was compromised but that did not result in injury. (14) "Pat-down search" means a body search done outside of a person's clothing with the intention of locating suspected contraband. (15) "Personal property search" means a search which includes going through a program participant's personal property and/or room including closet, bed, desk, dresser drawers, backpacks, etc., with the intention of looking for contraband. (16) "Physical escort" means the temporary touching or holding of the hand, wrist, arm, shoulder, or back for the purpose of inducing a program participant to walk to a safe location. (17) "Physical restraint" means a personal restriction that immobilizes or reduces the ability of the free movement of an individual's arms, legs, or head. Such term does not include physical escort. (18) "Program participant-to-staff ratio" means the number of program participants in care per each on-duty awake direct care staff member. (19) "Seclusion" means a behavior control technique involving locked isolation in which the program participant is physically prevented from leaving. Such term does not include time-out. (20) "Self-administration assistance" means providing necessary assistance to any program participant in taking their medication, including: (a) removing medication containers from secured storage; (b) providing verbal suggestions, promoting, reminding, gesturing or providing a written guide for self-administering medications; (c) handling a prefilled, labeled medication holder, labeled unit dose container, syringe, or original marked, labeled container from the pharmacy; (d) opening the lid of the above container for the program participant; (e) guiding the hand of the program participant to self-administer the medication; (f) holding and assisting the program participant in drinking fluid to assist in the swallowing of oral medications; and (g) assisting with removal of a medication from a container for program participant with a physical disability which prevents independence in the act. (21) "Serious incident" means suicide attempt, use of excessive physical force by staff, use of a restraint or seclusion, physical or sexual assault of a program participant by staff, or another program participant, injury to a program participant which requires emergency medical care, known, or suspected abuse or neglect (as defined in 41-3-102 , MCA), of a program participant by staff or another program participant, a near miss or the death of a program participant, elopement, or an incident that involves law enforcement. (22) "Time-out" means the restriction of a program participant for a period of time to a designated unlocked area from which the program participant is not physically prevented from leaving for the purpose of providing the program participant the opportunity to regain self-control. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-802 , 52-2-803 , 52-2-805 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19; AMD, 2024 MAR p. 2155, Eff. 9/7/24. 37.99.106 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: APPLICATION OF OTHER RULES (1) Any program that includes in its marketing, advertising, information packet, or other similar document reference to providing primary, inpatient, or residential chemical dependency treatment must be licensed by the Montana Department of Public Health and Human Services under Title 50, chapter 5, MCA. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.107 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: LICENSING FEE SCHEDULE (1) Programs must submit payment for licensure annually. (2) Licensing fees are based on the number of participants the program is licensed to serve as shown in the table below. Number of participants Licensing Fees 1-10 participants $1,688 11-25 participants $4,345 26-50 participants $8,138 51 and more participants $13,313 (3) All fees provided for in this rule are nonrefundable and are not prorated for portions of the licensing period. (4) All fees must be paid in full by July 1 of each year. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-804 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.109 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: PROCEDURE FOR OBTAINING A LICENSE: ISSUANCE AND RENEWAL OF A LICENSE (1) Application for a program license must be made on an application form provided by the department. (2) Renewal applications must be received within 30 days prior to the expiration date of the current license. (3) The program must submit all written program management policies and procedures to the department for approval with the initial application. Policies and procedures must comply with requirements outlined in this chapter. (4) Upon receipt of a complete initial or renewal application, the department must conduct an on-site licensing survey to determine if the applicant meets all applicable licensing requirements. The on-site licensing survey may be unannounced. (5) If the department determines during the survey that the applicant is out of compliance with the applicable licensing requirements, the department will notify the applicant of the specific deficiencies and the applicant must submit a written plan of correction within ten working days of the department's notification of noncompliance specifying how compliance will be made and maintained in the future. (6) The department must receive all required information and approve the plan of correction prior to issuing a license. (7) If all licensing requirements are met and the fee has been paid in full, the department will issue a license for a period of up to three years. (a) A three-year license may be issued to a program that has received no deficiencies within the last licensed period and licensing survey. (b) A two-year license may be issued to a program that has received minor deficiencies that do not significantly affect or threaten the health, safety, and welfare of any program participant. (c) A one-year license may be issued to any program: (i) that has been in operation for less than one year; (ii) upon a change in ownership; (iii) that has received deficiencies within the last licensed period or licensing survey that threaten the health, safety, and welfare of program participants or staff; or (iv) that has received multiple deficiencies or repeat deficiencies. (8) The department may in its discretion issue a provisional license for a period not to exceed six months to any license applicant which: (a) has met all licensing requirements for fire safety; and (b) has agreed in writing to comply fully with all licensing requirements established by these rules within the time period covered by the provisional license. (9) Licensed premises must be open to inspection by the department or its authorized agent and access to all records must be granted to the department at all reasonable times. (10) The program will only admit the number of program participants specified on the license. (11) The current license must be publicly displayed at the program. (12) A program's license is nontransferable. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-805 , 52-2-806 , 52-2-807 , 52-2-808 , 52-2-809 , 52-2-810 , 52-2-811 History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.110 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: LICENSE DENIAL, SUSPENSION, RESTRICTION, AND REVOCATION (1) The department, after written notice to the applicant or program, may deny, suspend, cancel, reduce, modify, or revoke a license upon a finding of any of the following: (a) the program is not in compliance with fire safety standards; (b) the program is not in substantial compliance with other licensing requirements established by this chapter; (c) the program has made any misrepresentations to the department, either negligent or intentional, regarding any aspect of its operations or facility; (d) the program has failed to use payments for the support of the program participants; (e) the program, persons associated with the program, any staff member, or persons living at the program have been named as the perpetrator in a substantiated report of abuse or neglect; (f) the program, persons associated with the program, any staff member or persons living at the program have violated provisions of this chapter that resulted in child abuse or neglect; (g) the program, persons associated with the program or any staff member do not meet the requirements in ARM 37.99.148 ; (h) the program failed to report an incident of abuse or neglect to the department or its local affiliate as required in 41-3-201 , MCA; (i) it is determined on the basis of a department or law enforcement investigation that the program, persons associated with the program, any staff member, or anyone living in a program may pose any risk or threat to the safety or welfare of program participants; (j) the program has failed to provide an acceptable written plan of correction as specified in ARM 37.99.109 ; (k) the program did not pay the licensure fee as required in ARM 37.99.107 ; or (l) the program employs or has persons living at the program that do not have an approved background check as required in ARM 37.99.126 . (2) At the discretion of the department and for protection of the program participants, program participants may be removed immediately upon receipt of a report of sexual or physical abuse or neglect by the program. (3) Suspension or revocation of a license may be immediate upon a determination by the department that emergency action is required based on findings including, but not limited to the following situations: (a) upon referral of suspected child abuse or neglect regarding a program, the initial investigation reveals that there are reasonable grounds to believe that a program participant may be in danger of harm; (b) the department requests and is denied access to the program, program participants, or staff; or (c) through a licensing investigation, it is determined that the program, persons associated with the program, any staff member, or persons living at the program have violated a licensing regulation that results in harm to a program participant which falls within the definitions of child abuse and neglect set out in 41-3-102 , MCA, whether or not a criminal prosecution is initiated. (4) Until the issuance of a contrary decision by the department the denial, suspension, cancellation, reduction, modification, or revocation of a license will remain effective and enforceable. (5) Any person denied a license under the provisions of this subchapter, or whose license has been denied, suspended, canceled, reduced, modified, or revoked may request a hearing as provided in ARM 37.5.304 , 37.5.305 , 37.5.307 , 37.5.310 , 37.5.313 , 37.5.316 , 37.5.318 , 37.5.322 , 37.5.325 , 37.5.328 , 37.5.331 , 37.5.334 , and 37.5.337 . (6) Nothing in these rules precludes the department from utilizing provisions of the Montana Administrative Procedure Act, including but not limited to summary suspension under 2-4-631 (3), MCA. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-804 , 52-2-805 , 52-2-806 , 52-2-807 , 52-2-808 , 52-2-809 , 52-2-810 , 52-2-811 , MCA, NEW, 2019 MAR p. 2029, Eff. 11/9/19. History: 37.99.115 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: WRITTEN POLICY AND PROCEDURE (1) A current written policy and procedure manual that includes all policies required in this chapter and describes all services provided in the program, must be developed, implemented, and maintained at the program. The manual must be available to staff, program participants, program participants' parent/legal guardian, and the department and must be complied with by all program personnel and its agents. (2) The policy and procedure manual must be submitted with the initial application for department approval. (3) Any updates to the policy and procedure manual must be submitted to the department for approval 30 days prior to implementing the policy. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19; AMD, 2024 MAR p. 2155, Eff. 9/7/24. 37.99.117 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: ADMISSIONS (1) The program will admit only those program participants for whom it has an operational program and who meet its admissions policies. (2) The program must have written policies and procedures for screening all referrals. (3) The program must have a written admissions policy and procedures which include: (a) the age, sex, and behavioral and/or emotional needs of adolescents served; (b) verifying of legal authority to place or remove a program participant from the program; (c) a description of the intake process for the program participants; (d) a description of the orientation provided to program participants; and (e) an initial assessment of the program participant's emotional, medical, developmental, social, and behavioral status that must be conducted at the time of admission. (4) The admission person or committee must review all preplacement referral information to determine the appropriateness of placement, including age and developmental needs of adolescents accepted into the program. (5) The program's policies and procedures must provide for and encourage a preplacement process with the program participant and family. (6) Placements may only be accepted from the parent/legal guardian of the program participant. (7) The admissions policy may not limit contact with the program participant's family for no more than 7 days after admission. (8) A program must have written orientation policies and procedures for admission to the program that include: (a) a procedure for ensuring that each program participant receives a personal orientation to the program as soon as appropriate, but no later than 24 hours after admission; (b) inventory of each program participant's belongings; (c) behavioral expectations; (d) information on privilege systems; (e) discipline policy; (f) health and safety procedures; (g) program rules; (h) information on the program's search policies, program participant rights, and grievance procedure; and (i) emergency evacuation procedures, including designated escape routes. (9) Documentation that is signed by both the program participant and the staff person(s) conducting the orientation must be placed in the program participant's file. (10) A program must maintain a list of current program participants to ensure all participants are accounted for and that staffing requirements are met in all circumstances. (11) A program must ensure compliance of each participant's placement with the Interstate Compact on the Placement of Children (ICPC), as provided in 41-4-101 , MCA, and ARM 37.50.901 . Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.118 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: WRITTEN AGREEMENT (1) The program must enter into a written agreement with the program participant's parent/legal guardian at the time of admission into the program. The written agreement must include: (a) the terms of the placement, the responsibilities of the program, and the responsibility of the parent/legal guardian; (b) a statement describing specific services the program will provide; (c) a statement describing the program participant's rights and the program's grievance policy; (d) a statement explaining the program participant's responsibilities including house rules; (e) a statement describing the communication policy, which must include a minimum of one confidential video telephonic communication contact per week between the youth and the youth's parents/legal guardian or foster parent(s), in addition to any therapeutic contact (family therapy), which: (i) is confidential, i.e., in a private setting with no other individuals in the vicinity of being able to see or hear what is being discussed; and (ii) is allocated a minimum of 15 minutes for the confidential video communication between youth and the youth's parents/legal guardian; (f) transportation of the program participant to and from medical appointments and activities; (g) a statement explaining specific charges for care and an itemized statement of what expenses in addition to the cost for care will be charged, including fines, penalties, or late fees that will be assessed; (h) a statement that the agreed-upon rate will not be changed unless 30 days' advance written notice is given to the program participant's parent/legal guardian; (i) criteria for requiring transfer or discharge of the program participant; (j) the refund policy; and (k) date and signature of the administrator and program participant's parent/legal guardian. (2) A copy of the agreement must be filed in the program participant's file and a copy must be provided to the program participant's parent/legal guardian. (3) When there are changes in services, financial arrangements, or requirements governing the written agreement, a new written agreement must be executed, or the original agreement must be updated by addendum. New agreements and any addenda must be signed and dated by the administrator and program participant's parent/legal guardian. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19; AMD, 2024 MAR p. 2155, Eff. 9/7/24. 37.99.119 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: DISCHARGE (1) The program must assist the program participant and family in preparing for the participant's discharge from the program. (2) At the time of discharge of a program participant from the program, a written discharge report must be completed, and include: (a) the program participant's name, date of birth, admission and discharge dates, reason for placement and discharge, and name of parent/legal guardian; (b) a written summary of services provided, including the program participant's participation and progress in the program, contact information of persons who conducted evaluations, and condition of the program participant at time of discharge; (c) the program participant's educational status; (d) medical, dental, and psychiatric care received during placement; (e) follow-up health care required; (f) current medications, dosage taken, number of times per day, and name of prescribing licensed health care professional; (g) program participant's reaction to discharge and whether or not the discharge was planned or unplanned; (h) recommendations for follow-up services; (i) an up-to-date inventory of the program participant's clothing and personal belongings; and (j) the signature of the staff member who prepared the report and the date of preparation. (3) The discharge report must be maintained by the program in the participant's file and a copy must be provided to the parent/legal guardian at the time of discharge. Written documentation that the discharge report was provided to the parent/legal guardian must be maintained in the program participant's file. (4) A program participant may only be discharged to the parent/legal guardian of the program participant. The program participant may be discharged to individuals other than the parent/legal guardian with written consent from the parent/legal guardian prior to discharge. (5) Unless otherwise prohibited by law or court order, a program must allow a parent or legal guardian to remove a youth from the program at any time. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19; AMD, 2024 MAR p. 2155, Eff. 9/7/24. 37.99.124 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: CASE PLAN (1) Each program must develop and implement a case plan for each program participant in care. (2) The case plan must include: (a) the program participant's physical and medical needs; (b) behavior management issues; (c) mental health services when appropriate; (d) measurable goals and objectives and corresponding time frames; (e) the responsibilities of the program participant, staff, and parent/legal guardian for meeting the goals and objectives; (f) education plans; and (g) discharge plans and estimated discharge date. (3) The initial case plan must: (a) be developed within seven business days after admission; and (b) be updated at least every 90 days from the day of development. (4) The program participant and the parent/guardian must be involved in developing and updating the case plan. (5) The program participant, parent/legal guardian, and program staff developing the case plan must sign and date the plan and plan updates. (6) A copy of the signed case plan must be provided to the parent/legal guardian and maintained in the program participant's file. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.125 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: RIGHTS AND GRIEVANCES (1) The program must have a written program participant rights policy that supports and protects the fundamental human, civil, constitutional, and statutory rights of all program participants. These rights must include: (a) to be treated with dignity and respect; (b) freedom from abuse, neglect, exploitation, harassment, and unnecessary physical restraint; (c) freedom from corporal, cruel, harsh, or unnecessary punishment, name calling, infliction of pain, or excessive physical exercise; (d) to adequate food, water, clothing, school supplies, and personal hygiene supplies; (e) to receive care and services according to individual need; (f) to educational services in accordance with Montana state law, if the program operates during the school year; (g) freedom from discrimination; (h) to a safe environment with respect for human dignity; (i) to the protection of the privacy of information and records regarding each program participant and the participant's family; (j) to communication and visitation privileges with family in person, by mail, or by phone; (k) to be allowed to contact the Montana abuse reporting hotline to report allegations of abuse and neglect; (l) to submit complaints and alleged violations of these rules, including a prohibition on retaliation against a program participant for submitting such a complaint; (m) to personal privacy, when it is not contrary to the treatment and safety needs of the program participant; and (n) for consideration of the program participant's opinions and recommendations when developing the case plan. (2) A program is prohibited from: (a) using physical discipline or the threat of physical discipline as a punishment, deterrent, or incentive; (b) unlawfully depriving a program participant of a basic necessity or a fundamental right, including education; (c) admitting a program participant who is under the age approved on the license or has a condition that the program is not authorized to treat pursuant to the program's admission policy; (d) using medical, chemical, or mechanical restraints; (e) using physical restraints, except in emergency circumstances to ensure the immediate physical safety of the program participant, a staff member, or others, when less restrictive interventions have been determined to be ineffective; (f) using a licensure candidate to provide mental health professional services if the parent/legal guardian of a program participant has not provided written consent; (g) using seclusion; and (h) sexually abusing, exploiting, or harassing a program participant. (3) The program must review the program participant rights policy with the program participant and parent/legal guardian at the time of admission. (a) The program staff reviewing the policy, the program participant, and parent/legal guardian of the program participant must sign a statement acknowledging the review. (b) The signed statement must be maintained in the program participant's file. (4) The program must have a written grievance policy which outlines the procedures to be followed by a program participant or parent/legal guardian in presenting a grievance to the program. (5) The program must review the grievance policy with the program participant and parent/legal guardian at the time of admission. (a) The program staff reviewing the policy, the program participant, and parent/legal guardian of the program participant must sign a statement acknowledging the review. (b) The signed statement must be maintained in the program participant's file. (6) Any written grievance report must be maintained in the program participant's file. The report must include the nature of the complaint, the date of the complaint, and a statement indicating how the issue was resolved. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19; AMD, 2024 MAR p. 2155, Eff. 9/7/24. 37.99.126 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: BACKGROUND CHECKS (1) All administrators, staff, volunteers, persons associated with the program, and any adult living at the program must complete a National Crime Information Center (NCIC) fingerprint-based background check from the Federal Bureau of Investigation. Results of the fingerprint-based background check must be documented prior to working or living at the program. (a) A name-based criminal background check may be completed pending the results of the fingerprint background check. The department must receive the request for the fingerprint check and the results of the name-based check must be documented prior to the staff working at the facility. (2) All administrators, staff, volunteers, person associated with the program, and any adult living at the program must complete a Montana Department of Public Health and Human Services child protective services background check, and, if applicable, a tribal child protective services background check, and a tribal criminal background check prior to working or living at the program. (3) If an applicant has lived outside the state within the past five years, a criminal and child protective background check must be conducted in every state that the applicant has resided in within the past five years. (4) All administrators, staff, volunteers, persons associated with the program, and any adult working or living at the program must complete a Montana Sexual and Violent Offender Registry Check (Montana SVOR) at https://app.doj.mt.gov/apps/svow/search.aspx and A National Sexual and Violent Registry Check (NSOPW) at https://www.nsopw.gov/ . (5) Results of all required criminal and child protective background checks and registry checks must be documented prior to working or living at a program. (6) The department will deny or revoke a license upon finding that: (a) any administrator, staff, volunteer, person associated with the program, or any adult living at the program has been convicted by a court of competent jurisdiction of a felony or misdemeanor involving but not limited to homicide, sexual intercourse without consent, sexual assault, aggravated assault, assault on a minor, assault on an officer, assault with a weapon, kidnapping, aggravated kidnapping, prostitution, robbery, or burglary; (b) any administrator, staff, volunteer, person associated with the program, or any adult living at the program has a conviction of a crime pertaining to children and families, including, but not limited to child abuse or neglect, incest, child sexual abuse, ritual abuse of a minor, felony partner and family member assault, child pornography, child prostitution, internet crimes involving children, felony endangering the welfare of a minor, felony unlawful transactions with children, or aggravated interference with parent-child contact; (c) any administrator, staff, volunteer, person associated with the program, or any adult living at the program has within the previous five years a felony conviction of a drug-related offense, including but not limited to use, distribution, or possession of manufacture of dangerous drugs, criminal possession of imitation dangerous drugs with the purpose to distribute, criminal possession, manufacture of, or delivery of drug paraphernalia, or driving under the influence of alcohol or other drugs; or (d) any administrator, staff, volunteer, person associated with the program, or any adult living at the program has within the previous five years a conviction for misdemeanor partner and family member assault, misdemeanor endangering the welfare of a child, misdemeanor unlawful transaction with a child, or a crime involving an abuse of the public trust; or (e) any administrator, staff, volunteer, person associated with the program, or any adult living at the program has been convicted of abuse, sexual abuse, neglect, or exploitation of an elderly person or a person with a developmental disability. (7) Any administrator, staff member, volunteer, persons associated with the program, or adult living at the program, who is charged with a crime involving children, physical or sexual violence against any person, or any felony drug-related offense and awaiting trial may not provide care or be present at the program pending the outcome of the criminal proceeding. (8) No administrator, staff, volunteer, person associated with the program, or any adult living at the program shall have been named as a perpetrator in a substantiated report of child abuse or neglect or listed on the Montana Sexual and Violent Offender Registry or National Sex Offender Public Website. (9) The program is responsible for assuring that the persons covered by this chapter have met these requirements prior to providing care. (10) No administrator, staff, volunteer, person associated with the program, or any adult living at the program may pose any potential threat to the health, safety, and well-being of the program participants. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.127 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: CHILD ABUSE OR NEGLECT AND SERIOUS INCIDENTS (1) A program must require each program participant, person associated with the program and staff member to read and sign a statement that clearly defines child abuse and neglect and outlines the individual's responsibility to report all known or suspected incidents of child abuse or neglect of any program participant to the department within 24 hours. (2) Any program staff or person associated with the program who knows or has reasonable cause to suspect that an incident of child abuse or neglect has occurred must report within 24 hours of the incident to the program administrator, or a person designated by the program administrator, and to the state child abuse hotline, (866) 820- 5437 as required in 41-3-201 , MCA. The program must fully cooperate with any investigation conducted as a result of the report. (3) A program must have written policies and procedures for handling any suspected incident of child abuse or neglect, including: (a) a procedure for ensuring that the staff member suspected does not continue to provide direct care until an investigation is completed; (b) a procedure for developing a safety plan approved by the department which protects the program participants and staff until the investigation is complete; (c) a procedure for taking appropriate disciplinary measures against any staff member involved in an incident of child abuse or neglect, including termination, retraining, or any other action geared towards the prevention of future incidents; and (d) sexually abusing, exploiting, or harassing a program participant. (4) Any serious incident involving a program participant must be reported in writing within one business day to the department's licensure bureau. The report must include: (a) the date and time of the incident; (b) all program participants and staff member(s) involved; (c) a description of the incident and the circumstances surrounding it; (d) a statement written by the staff member that was involved in the incident or witnessed the incident; and (e) documentation of the date and time the incident was reported to the parent/legal guardian. (5) A copy of the report must be maintained in the program participant's file. (6) The program must cooperate with all licensing surveys and investigations, which may include private one-on-one interviews with staff and program participants. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-5-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19; AMD, 2024 MAR p. 2155, Eff. 9/7/24. 37.99.132 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: PHYSICAL ENVIRONMENT (1) Each program must comply with all applicable federal, state, and local regulations, laws, and building codes. (2) Adequate space must be provided for all phases of daily living, including recreation, privacy, group activities, and visits from family, friends, and community acquaintances. (3) Program participants must have indoor areas of at least 40 square feet of floor space per program participant for quiet, reading, study, relaxing, and recreation. The minimum space requirement may not include halls, kitchens, and any rooms not used by program participants. (4) A bedroom must contain at least 50 square feet of floor space per person. Bedrooms for single occupancy must have at least 80 square feet. (5) The maximum number of program participants per bedroom must not exceed four. The bedrooms must have floor to ceiling walls. (6) Program participants sharing a bedroom must be no more than 3 years in age apart. (7) The program must provide: (a) at least one toilet for every eight program participants; and (b) one bathing facility for every eight program participants. (8) All rooms with toilets or shower and bathing facilities must have an operable window to the outside or must be exhausted to the outside by a mechanical ventilation system. (9) Each program participant must have access to a bathroom without entering another bedroom, the kitchen, or dining areas. (10) Hot and cold water must be available in all kitchens, bathrooms, and laundry. The temperature of hot water supplied to handwashing and bathing facilities must not exceed 120ºF. (11) For adequate housekeeping the program must ensure that: (a) the building and grounds are free, to the extent possible, of harborage for insects, rodents, and other vermin; (b) all electrical, mechanical, plumbing, fire protection, heating, and sewage disposal systems must be kept in operational condition; (c) the floors, walls, ceilings, furnishings, and other equipment is clean and in good repair free of hazards, and offensive odors; (d) cleaning equipment and supplies are provided in sufficient quantity to meet the housekeeping needs of the facility; and (e) a maintenance policy and schedule, which describes the regular maintenance of the facility, is adhered to. (12) All rooms and hallways must have adequate lighting. (13) Programs must post a sign within the facility that is accessible to all program participants and to the public. The sign must provide information on what agency should be contacted to report a violation of law or policy and must include contact information for the Office of Inspector General Licensure Bureau, the Montana Child Abuse and Neglect Hotline ( 866-820-5437 ), and local law enforcement. (14) With respect to any conditions in existence in licensed programs prior to October 1, 2019, the specific requirements in this rule may be modified by the department to allow alternative arrangements that will provide that same level of safety to program participants and staff. In no case will the modification afford less safety than that which, in the discretion of the department, would be provided by compliance with the corresponding requirement in this rule. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , 52-2-810 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19; AMD, 2024 MAR p. 2155, Eff. 9/7/24. 37.99.133 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: LAUNDRY AND BEDDING (1) If a program processes its laundry on site, it must: (a) use areas solely for laundry purposes; (b) equip the laundry room with at least one mechanical washer and hot-air tumble dryer, handwashing facilities, mechanical ventilation to the outside, a fresh air supply, and a hot water supply system which supplies the washer with water of at least 160ºF (71ºC) during each use. If the laundry water temperature is less than 160ºF, chemical and detergent suitable to the water temperature and the manufacturer's recommended product time of exposure must be utilized; (c) sort and store soiled laundry in an area separate from that used to sort and store clean laundry; (d) provide well maintained carts or other containers impervious to moisture to transport laundry, keeping those used for soiled laundry separate from those used for clean laundry; (e) dry all bed linen, towels, and washcloths in a manner that protects against contamination; (f) protect clean laundry from contamination; and (g) ensure that program staff handling laundry cover their clothes while working with soiled laundry, use separate clean covering for their clothes while handling clean laundry, and wash their hands both after working with soiled laundry and before they handle clean laundry. (2) If laundry is cleaned off-site, the program must utilize a commercial laundry which satisfies the requirements stated in (1). (3) A program must provide each program participant with: (a) a bed with a moisture-proof mattress or moisture-proof mattress cover and mattress pad; (b) clean bed linen in good condition; (c) a supply of clean bed linen on hand sufficient to change beds often enough to keep them clean, dry, and free from odors; (d) supply each program participant at all times with clean towels and washcloths; and (e) enough blankets to maintain warmth while sleeping. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.134 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: WATER SUPPLY (1) An adequate and potable supply of water must be provided. (2) Before a license may be issued, a program using an individual, shared, or multiple user water supply must submit the following to the department or its designee: (a) satisfactory coliform bacteria and nitrate test results as specified in ARM Title 17, chapter 38, subchapter 2; and (b) the results of an onsite sanitary survey of the water supply system to detect sanitary deficiencies. (3) A supplier of an individual, shared, or multiple user water supply shall conduct a coliform bacteria test of the system at least twice a year with one sample collected between April 1 through June 30 and the second sample collected between August 1 through October 31 and conduct a nitrate test of the system at least once every three years. Water tests must be analyzed at a certified laboratory. A supplier must keep sampling result records for at least three years. (4) A public water supply system must be constructed and operated in accordance to current applicable laws as regulated by the Montana Department of Environmental Quality. (5) Nonpotable water sources must be marked "not for human consumption." (6) Plumbing must be installed and maintained in a manner to prevent cross connections between the potable water supply and any nonpotable or questionable water supply or any source of pollution through which the potable water supply might be contaminated. The potable water system must be installed to preclude the possibility of backflow. A hose may not be attached to a faucet unless a backflow prevention device is installed. (7) A water supply system is determined to have failed and requires treatment, replacement, repair, or disinfection, when the water supply becomes unsafe, or when it exceeds the maximum contaminant levels specified in ARM Title 17, chapter 38, subchapter 2. A water supply system is inadequate when it is found to be less than 20 psi measured at the extremity of the distribution line during the instantaneous peak usage. (8) Extension, alteration, repair, or replacement of a water supply system or development of a new water supply system must be in accordance with all applicable state and local laws. (9) Bottled and packaged potable water must be obtained from a licensed and approved source and be handled and stored in a way that protects it from contamination. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.135 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: SEWAGE SYSTEM AND SOLID WASTE (1) An adequate and safe wastewater system must be provided for conveying, treating, and disposing of all sewage. Immediate measures must be taken to alleviate health and sanitation hazards caused by wastewater at the program when they occur. (2) All sewage, including liquid waste, must be disposed of by a public sewage treatment and disposal system constructed and operated in accordance to applicable state and local laws. (3) A wastewater system has failed and requires replacement or repair if any of the following conditions occur: (a) the system fails to accept, treat, or dispose of wastewater as designed; (b) effluent from the wastewater system contaminates a potable water supply or state waters; or (c) the wastewater system is subjected to mechanical failure, including electrical outage, or collapse or breakage of a septic tank, lead line, or drain field line. (4) Extension, alteration, replacement, or repair of any wastewater system must be done in accordance with all applicable state and local laws. (5) Mop water or soiled cleaning water may not be disposed of in any sink other than a mop or utility sink or a toilet. (6) Solid waste must be collected, stored, and disposed of in a manner that does not create a sanitary nuisance. Solid waste must be removed from the premises at least weekly to a licensed solid waste disposal facility. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.136 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: FIRE SAFETY (1) The department adopts and incorporates by reference the current edition of the locally adopted Fire Code (FC), which sets forth the fire safety regulations that apply to all programs. (2) The local or state fire authority having jurisdiction must annually certify a program for fire and life safety. (3) Smoke detectors and smoke alarms must be installed and operated in accordance with the FC set forth in the locally adopted FC. (4) Carbon monoxide detectors must be installed and operated in accordance with the FC. (5) A workable portable fire extinguisher, with a minimum rating of 2A10BC, must be located on each floor of the facility. Fire extinguishers must be: (a) mounted on the wall not to exceed five feet from handle to floor and no closer than four inches from the floor; (b) no more than 75 feet travel distance apart; (c) inspected, recharged, and tagged at least once a year by a person certified by the state to perform such services; and (d) not obstructed or obscured from view. (6) Program staff must check battery operated smoke detectors at least once each month and the batteries must be replaced at least once each year. Documentation, including the date and the signature of the person checking or replacing the batteries, must be maintained at the facility. (7) Integrated dial-out-smoke detection systems that are monitored from an outside source must have the date showing the most recent maintenance. Maintenance must occur once per year. (8) Orientation for staff and program participants must include instruction of the program's fire evacuation procedure. The fire evacuation procedure must be posted in a conspicuous place in the program. (9) All exits must be clear and unobstructed at all times. (10) Paint, flammable liquids, and other combustible material must be kept in locked storage away from heat sources or in outbuildings not used by the program participants. (11) The program must conduct at least one fire drill per quarter per each work shift. Drill observations must be documented and maintained in the program files for at least three years. The documentation must include: (a) time and location of the drill; (b) identification of participating staff; (c) problems identified during the drill; and (d) steps taken to correct such problems. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , 52-2-810 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.137 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: EMERGENCY AND EVACUATION PLANS (1) A program must have and follow a written emergency plan developed in conjunction with emergency services in the community, and it must include specific procedures for evacuations, disasters, medical emergencies, hostage situations, casualties, missing program participants, and other serious incidents identified by the program. (2) The emergency plan must include: (a) designation of authority and staff assignment; (b) a specific evacuation plan; (c) provisions for transportation and relocation of program participants when necessary; (d) provisions for supervision of program participants after an evacuation or relocation; (e) provisions for the instruction of all participants on how to respond in the case of an emergency; (f) provisions for arranging medical care and notifying the program participant's licensed health care professional, and parent/legal guardian; and (g) maintenance and repair of essential equipment including a two-way radio. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.138 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: SAFETY (1) A program must have written policies and procedures on safety and equipment. (2) There must be a first aid kit with sufficient supplies available at all times. A first aid kit must: (a) be readily available on site as well as in all vehicles used by the program; (b) meet the standards of an appropriate national organization for the activity being conducted and the location and environment being used; (c) be reviewed with new staff for contents and use; and (d) be inventoried on a quarterly basis. (3) Policies and procedures must be in place for the safe use and storage of fuels and all heat sources, including inaccessibility to program participants when not being used under the direct supervision of staff. (4) Cleaning materials, flammable liquids, detergents, aerosol cans, and other poisonous and toxic materials must be kept in their original containers and in a place inaccessible to program participants. They must be used in such a way that will not contaminate play surfaces, food, food preparation areas, or constitute a hazard to the program participants. Bio-contaminants including blood, bodily fluids, and other infectious materials must be properly disposed of. (5) No extension cord will be used as permanent wiring. All appliances, lamp cords, and exposed light sockets must be suitably protected to prevent electrocution. (6) Any pet or animal present at the program indoors or outdoors, must be in good health, show no evidence of carrying disease, and be a friendly companion for the program participants. The provider is responsible for maintaining the animal's vaccinations and vaccination records. These records must be made available to the department upon request. The program must make reasonable efforts to keep stray animals off the premises. (7) Emergency information for program participants must be easily accessible at the program. Emergency information for each program participant must include: (a) the name, address, telephone number, and relationship of a designated person to be contacted in case of an emergency; (b) the name, address, telephone number of the program participant's licensed health care professionals or source of health care; (c) the name, address, telephone number, and relationship of the person able to give consent for emergency medical treatment; (d) documentation of any medical conditions that may affect care including but not limited to known allergies; (e) a signed release for emergency medical treatment from the parent/legal guardian; and (f) a copy of the program participant's current medical insurance card or insurance information when a card is not available to providers. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.145 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: CASE RECORDS (1) A program must maintain a written case record for each program participant which contains administrative, treatment, and educational data from the time of admission until the time the program participant is discharged from the program. (2) The case record must include: (a) the name, sex, and birth date of the program participant; (b) the name, address, and telephone number of the parent/legal guardian of the program participant; (c) date of admission; (d) current immunization records and documentation of exemptions per program policy; (e) date of discharge, person and signature whom the program participant was released to, and signed discharge summary; (f) all documents related to the referral of the program participant to the program; (g) current custody and parent/legal guardianship documents or other documents verifying legal custody of the parent/legal guardian placing the program participant per program policy; (h) the program participant's court status, if applicable; (i) a copy of the program participant's birth certificate; (j) consent forms signed by the parent/legal guardian prior to placement allowing the program to authorize all necessary medical care, routine tests, immunization, and emergency medical or surgical treatment; (k) cumulative health records including medical history provided by the parent/legal guardian; (l) education records and reports, including but not limited to report cards and individual education plan (IEP) reports; (m) treatment or clinical records and reports; (n) records of physical restraints and special or serious incidents; (o) case plans, treatment plans, all updates and related material; (p) social assessment that is current to date of placement; and (q) an immediate needs assessment and assigned responsibilities. (3) A copy of the signed physical examination form must be maintained in the file for outdoor programs. (4) Program participant records must be maintained at the program for a minimum of six years. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.146 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: CONFIDENTIALITY OF RECORDS AND INFORMATION (1) All records maintained by a program and all personal information made available to a program pertaining to a program participant must be kept confidential and are not available to any person, agency, or organization except as specified in (2) and (3). (2) All records pertaining to a program participant are available upon request to: (a) the program participant's parent/legal guardian or attorney absent specific and compelling reasons for refusing such records; (b) a court with continuing jurisdiction over the placement of the program participant or any court of competent jurisdiction issuing an order for such records; (c) a program participant to whom the records pertain, absent specific and compelling reasons for refusing specific records; or (d) an adult who was formerly the program participant in care to whom the records pertain. (3) Records pertaining to program participants must be available to the department for the purposes of licensing, relicensing, or investigating a complaint of the program. (4) Necessary information pertaining to the program participant must be disclosed when program staff are following mandatory reporting requirements as outlined in this rule and within the scope of an individual's license. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , 52-2-811 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.147 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: REPORTS (1) The program must submit to the department, upon its request, any reports required by federal law, state law, or regulations. (2) The program must report any of the following changes in writing to the department's licensure bureau, prior to the effective date of the change: (a) a change of administrator; (b) a change in location of which the department must approve prior to the move; (c) a change in the name of the program; or (d) any significant change in the program policies or procedures or services. (3) Runaways shall be reported immediately to the police and parent/legal guardian and within the next working day to the licensure bureau. (4) Disasters or emergencies which require relocation of program participants or closure of the program must be reported to the licensure bureau within the next working day. (5) Any serious incident as defined in this subchapter must be reported in writing to the licensure bureau within 24 hours of the incident. (6) Any fire or other incident that caused significant damage to the property must be reported to the licensure bureau within 24 hours of the incident. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-808 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.148 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: GENERAL REQUIREMENTS FOR ALL ADMINISTRATORS, STAFF MEMBERS, AND VOLUNTEERS (1) A program must have written personnel and program policies and procedures covering the following items: (a) screening procedure for all applicants; (b) job qualifications for all positions; (c) job descriptions for all positions; (d) supervisory structure; and (e) performance evaluations. (2) In addition to the specific requirements set out in this chapter, all staff working in a program must: (a) be at least 20 years of age; (b) have a high school diploma or GED; and (c) be physically, mentally, and emotionally competent to care for program participants. (3) Any administrator, staff member, volunteer, or other person whose behavior or health status endangers the program participants may not be allowed at the program. (4) Program volunteers must: (a) not be included in the program participant-to-staff ratios; (b) be under the supervision of program staff; (c) follow written policies and procedures developed by the program defining the responsibilities, limitations, and supervision of volunteers; (d) complete all required background checks; and (e) be provided orientation and initial training. The training must include orientation on all program policies and procedures. (5) All program staff who transport program participants must have a valid driver's license and, while transporting program participants, follow all laws applicable to driving in Montana. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.149 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: PERSONNEL RECORDS (1) The program is responsible for maintaining a file on each administrator, person associated with the program, staff member, or volunteer. Files may be inspected by the department at any time. If the file is not maintained at the program it must be available to the department within 24 hours of the request. (2) The file must contain: (a) application for employment; (b) written results of at least two references; (c) record of orientation and ongoing training; (d) periodic performance evaluations; (e) a copy of current credentials, certification, or professional licenses required to perform the duties described in the job description; (f) documentation of criminal background check as specified in ARM 37.99.126 ; (g) documentation of child protective services background checks as specified in ARM 37.99.126 ; (h) documentation of Montana and National registry checks as specified in ARM 37.99.126 ; (i) a copy of current driver's license for employees transporting program participants; and (j) any other employee records required by this subchapter. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.150 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: QUALITY ASSESSMENT (1) The program must implement and maintain an active quality assessment program for improving policies, procedures, and services. At a minimum, the quality assessment program must include procedures for: (a) conducting program participant satisfaction surveys at least annually which are maintained and filed at the program; (b) maintaining records on the occurrence, duration, and frequency of physical restraints used; and (c) reviewing, on an ongoing basis, serious incident reports, grievances, complaints, medication errors, and the use of physical restraints with special attention given to identifying patterns and making necessary changes in how services are provided. (2) The program must prepare and maintain, on file, an annual report including improvements made as a result of the quality assessment activities specified in this rule. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.151 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: ADMINISTRATOR (1) Each program must employ an administrator that is responsible for the day-to-day operation of the program. (2) The administrator must have formal training and/or experience in residential or outdoor programs and demonstrates the ability to perform the functions and duties required in these rules. (3) In the absence of the administrator, a staff member must be designated to oversee the operation of the program during the administrator's absence. The administrator or designee must be in charge, on call, and physically available on a daily basis as needed, and must ensure there are sufficient, qualified staff so that the care, well-being, health, and safety needs of the program participants are met at all times. (a) If the administrator will be absent from the program for more than 30 continuous days, the department must be given written notice of the individual who has been appointed the designee. The appointed designee must meet the requirements for an administrator. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.152 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: STAFF (1) Each program must maintain the minimum program participant to awake-staff ratios: (a) from 7:00 a.m. to 11:00 p.m., eight program participants to one staff; (b) from 11:00 p.m. to 7:00 a.m., or any other reasonable eight-hour period of time when program participants are generally sleeping, 16 program participants to one staff; and (c) programs must have at least one awake night staff in each building housing program participants regardless of the number of participants. (2) Outdoor programs must meet staff ratios defined in ARM 37.99.210 . (3) During regular school hours when program participants are not normally present, at least one on-call staff must be available for duty within 30 minutes of notification that they are needed. (4) The program must have a policy that specifies a nighttime safety protocol that outlines program staff responsibility for monitoring the program participants. (5) Sufficient staff must be employed to meet the supervision needs of the program participants and implement each program participant's individualized case plan. (6) Mental health professionals must be licensed as defined in this rule and be employed in sufficient number to meet the mental health needs of program participants as outlined in the program description. (7) A registered nurse or licensed practical nurse must be employed to meet the needs of the program participants as outlined in the program description. (8) Any program that includes in its program description, marketing, advertising, information packet, or other similar document reference to providing chemical dependency services must employ licensed addiction counselors in sufficient number to meet the needs of the program participants. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.153 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: STAFF TRAINING (1) A program must have written policies, procedures, and initial and ongoing training curriculum that meets the minimum requirements in this rule. (2) Programs must provide adequate and timely training to ensure the safety of program participants. (3) All program staff must complete a minimum of 24 hours of orientation training consisting of the following minimum requirements: (a) an overview of the program's policy, procedures, organization, and services; (b) mandatory child abuse reporting laws; (c) behavioral management techniques; (d) fire safety, including emergency evacuation routes; (e) confidentiality; (f) suicide prevention; (g) emergency medical procedures; (h) report writing including the development and maintenance of logs and journals; (i) program participant rights as outlined in ARM 37.99.125 ; and (j) hours required for on-the-job training. (4) Orientation training must be completed and documented before the staff person may count in the staff ratio as specified in ARM 37.99.172 and 37.99.210 . (5) All program staff must complete the following certification training within six months of hire: (a) the use of de-escalation training and methods of managing program participants as described in the program's policies and ARM 37.99.170 ; (b) first aid and hands-on CPR certification; and (c) maintain and update these trainings and certifications as required. (6) Program staff may not work alone without completing the requirements of (5). (7) The program must provide ongoing training for staff to maintain and improve proficiency in their knowledge and skills. Training must be a minimum of 20 hours annually thereafter and appropriate for the level of care provided. (8) All training must be documented and kept on file for each staff member, administrator, and volunteer. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.159 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: PHYSICAL CARE (1) Every program participant must have access to the services of at least one licensed health care professional as defined in 50-5-101 , MCA. (2) Medical, dental, psychiatric, psychological care, and counseling services will be arranged for the program participant as needed. (3) If a program participant has not received a complete physical examination within a year prior to placement, within 30 days after admission the program must arrange for a complete physical examination and annually thereafter. (4) If a program participant has not had a dental examination within a year prior to placement, the program must arrange for the program participant to have a dental examination within 90 days after admission. All necessary dental work must be completed, and checkups must be arranged for the program participant at least annually. (5) If a program participant has not had an eye examination within a year prior to placement, the program must arrange for the program participant to have an eye examination within 90 days after admission. All necessary checkups must be arranged for the program participant at least annually. (6) Provisions for medical, dental, or vision care must be made by the provider immediately upon the licensed health care professional's recommendation with notification to the parent/legal guardian. (7) Documentation of all required services must be in the program participant's file. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.160 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: MEDICATION STORAGE AND ADMINISTRATION (1) A program must have written policies and procedures regarding the storage, administration, and disposal of prescription, nonprescription, and over-the-counter medication. (2) All medication must be kept in a locked nonportable container, stored in its original container with the original prescription label. For medications taken on outings, all medication must be in the possession of a staff member trained to assist with the self-administration of medications. (3) Staff who assist with self-administration must be trained to assist in proper medication procedures. Training must be documented in each staff member's personnel file. (4) All prescription medications must be ordered by licensed health care professionals working within the scope of their practice. All prescription orders must contain the dosage to be given. (5) Psychotropic medication is prohibited unless a licensed health care professional working within the scope of that professional's practice determines that the medications are clinically indicated. (6) Under no circumstances may psychotropic or any other prescription or over-the-counter medication be given for disciplinary purposes, for the convenience of the staff, or as a substitute for other appropriate treatment services. (7) A written record of all medications administered to a program participant must be maintained and include: (a) program participant's name; (b) name and dosage of the medication; (c) the date and time the medication was taken or was refused by the program participant; (d) name of the staff member who assisted in the self-administration of the medication; and (e) documentation of any medication errors, results of errors, and any effects observed. (8) Prescribed medication may not be stopped or changed in dosage or administration without first consulting with a licensed health care professional. Results of the consultation must be recorded in the medication record. (9) Parent/legal guardian must be notified of all medications prescribed to program participant including medication changes. Documentation of notification must be maintained in the medication record. (10) All unused and expired medication must be properly disposed of and documented in the medication record. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.161 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: CARE AND GUIDANCE (1) A program must provide to each program participant sufficient staff to ensure: (a) appropriate medical care, supervision, safety, treatment, and guidance; (b) opportunities for educational, social, and cultural growth through suitable reading materials, toys, activities, and equipment; and (c) opportunities to associate with peer groups in school and community settings. (2) A program must arrange for contact with each program participant's parent/legal guardian and approved family members. (3) The program must assist the parent/legal guardian with referral for support services. (4) The provider must assist the program participant and, when appropriate, the family, in preparing for the program participant's discharge. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.162 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: NUTRITION (1) A program must provide for or serve three regular, well-balanced meals per day, and snacks. Foods must be served in amounts and a variety sufficient to meet the nutritional needs of each program participant. (2) Special diets must be provided for program participants as ordered in writing by a licensed health care professional. Such orders must be kept on file by the program. (3) Food may not be altered, modified, restricted, or prohibited as a means of punishment, discipline, or as a behavioral modification technique. (4) Records of menus as served must be filed at the program for three months after the date of service for review by the department. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.163 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: FOOD PREPARATION AND HANDLING (1) Safe food handling and preparation practices must be followed in all programs. All food must be from an approved source and must be transported, labeled, stored, covered, prepared, and served in a sanitary manner to prevent contamination. (2) The program must have conveniently located hand washing facilities, supplied with liquid hand soap, disposable towels kept clean in a dispenser, and cleanable trash can. (3) Any staff person or program participant handling or preparing food must thoroughly wash hands, wrists, and exposed arms with soap and warm running water for at least 20 seconds: (a) before and after handling food; (b) after using the bathroom; and (c) after handling raw food such as raw meat, uncooked eggs, and unwashed fruits and vegetables. (4) General food safety requirements must include: (a) all canned foods and dry ingredients must be stored in a designated area; (b) food cannot be stored on the floor; (c) food must be free from adulteration or other contamination and must be safe for human consumption; (d) food that is not stored in original containers must be dated, labeled, and covered; (e) all food must be cooked and reheated to the recommended temperature; (f) milk and other dairy products must be pasteurized; (g) use of home canned foods other than jams, jellies, and fruits is prohibited; (h) use of thermometers is required to check food temperatures; (i) cold storage of potentially hazardous food must be at 41°F or below; (j) frozen food must be kept frozen; (k) hot storage of potentially hazardous food must be 135°F or above; (l) each type of food must be stored and arranged so that cross-contamination of one type with another is prevented; and (m) raw fruits and vegetables must be thoroughly washed in potable water to remove soil and other contaminants before being cut, combined with other ingredients, cooked, served, or offered for human consumption in ready-to-eat form. Fruits and vegetables may be washed by using chemicals approved by the Environmental Protection Agency (EPA). (5) General health and safety requirements include the following: (a) Use clean cutting boards, knives, can openers, and other equipment and utensils for each type of food preparation to prevent cross-contamination. (b) A person with symptoms of a communicable disease that can be transmitted to foods or who is a carrier of such a disease may not work with food, clean equipment, or clean utensils. (c) When the regulatory authority has reasonable cause to suspect possible disease transmission within a program, the program must take appropriate action in accordance with ARM Title 37, chapter 114, regarding communicable disease control. (6) Equipment and utensil sanitation requirements include the following: (a) Kitchenware, tableware, and food contact surfaces must be washed, rinsed, and completely dried after each use. (b) Moist cloths used for wiping kitchen and dining area surfaces, equipment, and utensils must be placed in chemical sanitizer solution frequently enough and be of sufficient strength to maintain 200 to 400 parts per million (ppm) available chlorine or equivalent. (c) Sinks used for food preparation must be cleaned before beginning the preparation of the food. (7) A domestic style dishwasher may be used only if it is equipped with a heating element and the following conditions are met: (a) The dishwasher must be capable of washing and sanitizing all dishware, utensils, and food service equipment normally used for the preparation and service of a meal in one cycle. (b) The dishwasher must have water at a temperature of at least 165°F when it enters the machine, if it uses hot water for sanitization. (c) If it uses a heat cycle with a heating element for sanitization, the dishwasher must be allowed to run through the entire cycle before it is opened. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.164 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: PERSONAL NEEDS (1) The program must ensure that each program participant has clothing suitable to the program participant's age and size and comparable to the clothing of other adolescents in the community. (2) Program participants must have some choice in the selection of their clothing. (3) A program must provide necessary supplies and train program participant's in personal care, hygiene, and grooming. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.170 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: BEHAVIOR MANAGEMENT POLICIES (1) A program must have written behavior management policies and procedures which include a description of the model, program, or techniques to be used with program participants. The program must have policies addressing discipline, therapeutic de-escalation in crisis situations, crisis intervention and physical restraint, and time-out. Behavior management must be based on an individual assessment of each program participant's needs, stage of development, and behavior. It must be designed with the goal of teaching the program participant to manage their own behavior and be based on the concept of providing effective treatment by the least restrictive means. (2) The behavior management policies and procedures must prohibit: (a) the use of physical force, mechanical, chemical, or physical restraint as discipline; (b) pain compliance, aversive conditioning, and use of pressure point techniques; (c) placing of anything in or on a program participant's mouth; (d) cruel or excessive physical exercise, prolonged positions, or work assignments that produce unreasonable discomfort; (e) verbal abuse, ridicule, humiliation, profanity, and other forms of degradation directed at a program participant's family; (f) physical discipline of any means including but not limited to hitting, shaking, biting, or pinching; (g) locked confinement or seclusion; (h) withholding of necessary food, water, clothing, shelter, bedding, rest, medications as prescribed, medical care, or toilet use; (i) denial of visits or communication with the program participant's family; (j) isolation as punishment; and (k) any other form of punishment or discipline which subjects a program participant to pain, humiliation, or unnecessary isolation or restraint. (3) If program policies and procedures allow for disciplining a group of program participants for actions of one participant, the policies and procedures must clearly prescribe the circumstances and safeguards under which disciplining the group is allowed. (4) Any staff person involved in or witnessing an infraction of this rule shall complete an incident report clearly detailing the events of the infraction. The report must be completed prior to the end of the involved staff person's shift. (5) A copy of the incident report must be placed in the program participant's file and the incident must be reported to the licensure bureau and parent/legal guardian within 24 hours of its occurrence. (6) An authorized staff person must be notified of the incident immediately and: (a) begin an investigation within 24 hours of the incident; and (b) complete a written report and submit it to the licensure bureau within two days of completion of the investigation. (7) An investigation of the incident may be conducted by the department. (8) A complete report of any investigation conducted by the program must be placed in the provider's records and must be available for inspection by the department. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.171 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: TIME-OUT (1) A program must develop a written time-out policy and procedures which clearly provide: (a) length of time the program participant may remain in time-out which must be age appropriate; (b) guidelines for staff observation of the program participant when in time-out; (c) documentation required for each time-out that is directed by staff; (d) purpose of time-out; and (e) staff training pertaining to the use of time-out. (2) Staff may direct a program participant to time-out when the behavior is disruptive to the program participant's ability to learn, to participate appropriately, or to function appropriately with other participants and the activity, and when the other de-escalation techniques have failed. Restraint, seclusion, or confinement may not be used as part of time-out procedures. (3) Time-out may not be used as punishment. (4) Program participants placed in time-out must be reintroduced to the group in a sensitive and nonpunitive manner as soon as control is regained. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.172 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: USE OF CRISIS INTERVENTION AND PHYSICAL RESTRAINT STRATEGIES (1) The program must have written policies and procedures governing the appropriate use of crisis intervention and physical restraint methods if used by the program. (2) The crisis intervention and physical restraint policies and procedures must include evidence-based training and include: (a) suicide prevention training for all staff to include risk identification, screening and assessment, indicated interventions, safety planning, treatment, follow-up care, and documentation; (b) crisis prevention and verbal and nonverbal de-escalation techniques are the preferred methods and must be used first to manage behavior; (c) all staff must be trained in the program's crisis intervention, de-escalation techniques, and physical restraint methods; (d) physical restraint may only be used to safely control a program participant until the program participant can regain control of their own behavior; (e) physical restraint must only be used in the following circumstances: (i) when the program participant has failed to respond to de-escalation techniques and it is necessary to prevent harm to the program participant or others; or (ii) when a program participant's behavior puts themselves or others at substantial risk of harm and the program participant must be forcibly moved; (f) physical restraint must be used only until the program participant has regained control and must not exceed 15 consecutive minutes. If the program participant remains a danger to self or others after 15 minutes, the participant's record must include written documentation of attempts made to release the program participant from the restraint and the reasons that continuation of restraint is necessary; and (g) physical restraint may be used only by staff who are documented to be specifically trained in crisis intervention and physical restraint techniques. (3) The program policies and procedures must require the documentation of: (a) the specific behavior which required the physical restraint; (b) the specific attempts to de-escalate the situation before using physical restraint; (c) the length of time the physical restraint was applied including documentation of the time started and completed; (d) the identity of the specific staff member(s) involved in administering the physical restraint; (e) the type of physical restraint used; (f) any injuries to the program participant resulting from the physical restraint; (g) debriefing completed with the staff and program participant involved in the physical restraint; and (h) notification of the parent/legal guardian within 24 hours of restraint. (4) The documentation required in (3) must be submitted in writing to the Office of Inspector General Licensure Bureau within one business day of the physical restraint. (5) Program policies and procedures must require that whenever a physical restraint has been used on a program participant more than four times within a seven-day period, the program administrator or designee will review the program participant's situation to determine the suitability of the program participant to remain in the program, whether modification of the case plan is warranted, or whether staff need additional training in alternative therapeutic behavior management techniques. The program must take appropriate action as a result of the review. (6) Program policies and procedures must prohibit the application of a physical restraint if a program participant has a documented physical condition that would contradict its use, unless a health care professional has previously and specifically authorized its use in writing. Documentation must be maintained in the program participant's record. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19; AMD, 2024 MAR p. 2155, Eff. 9/7/24. 37.99.173 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: SEARCHES (1) The provisions of this rule apply to all searches by program staff of the program participant's person and personal property, including searches of personal correspondence. The facts and circumstances supporting a determination of reasonable cause for the search must be documented in the program participant's file. (2) Program participants may not be subjected to any search except as follows: (a) there is reasonable cause to believe that the search will result in discovery of contraband; (b) there is reasonable cause to believe that the search is necessary to alleviate a threat of harm to the program participant, other individuals, or staff; or (c) there is a court order/parole order in the program participant's case record allowing for searches. (3) The program must have written policy and procedures relating to searches, including pat-down searches, personal property searches, correspondence searches, urinalysis testing, and breathalyzer testing. The policies must include the following: (a) a procedure for documenting all searches, reasons for the search, who conducted the search, and the results of the search; (b) notification of the search policy to parent/legal guardian and program participant at time of admission; (c) a protocol for conducting personal property searches when the program participant is not available to be present for the search; (d) the consequences to a program participant when contraband is located; (e) description of what happens to contraband which has been located; and (f) pat-down searches on program participants, which must be conducted by staff persons of the same sex. (4) Staff must be trained in the proper protocol for all searches. Training must be documented in staff's personnel record. (5) Program participants may not be subjected to any of the following intrusive acts: (a) strip searches; (b) body cavity searches; or (c) video surveillance except in common areas such as the living room, kitchen, and hallways. (6) The program must have written policies and procedures prior to use of urinalysis testing for the purpose of determining drug and alcohol use which include: (a) procedures for obtaining samples for urinalysis testing; (b) procedures for processing urinalysis testing; and (c) consequence to the program participant when a urinalysis is positive. (7) The program must have written policies and procedures prior to use of breathalyzer testing for the purpose of determining drug and alcohol use which include: (a) procedures for operating the breathalyzer; and (b) consequences to the program participant when a breathalyzer is positive. (8) Program participants may not be subjected to urinalysis or breathalyzer testing unless the testing: (a) has been ordered by a court; (b) is required pursuant to a case plan for monitoring alcohol use, as approved by the parent/legal guardian; or (c) is requested by the program participant's parent/legal guardian, probation, parole, or correctional officer. (9) The program must notify the program participant's parent/legal guardian within 24 hours of every search, urinalysis testing, or breathalyzer testing performed on the program participant and the results. (10) Staff shall document compliance with program policies and procedures in connection with each search, urinalysis testing, or breathalyzer testing. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.174 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: CONTRABAND AND POTENTIAL WEAPONS (1) A program must define prohibited contraband in a written policy. (2) Law enforcement must be notified as appropriate when illegal contraband is discovered. (3) All contraband that is not illegal must be returned to the program participant's parent/legal guardian or destroyed in accordance with the program's contraband policy. When contraband is disposed of, at least two staff members must be present, and the disposal must be documented in the program participant's case record. (4) If contraband that is not illegal is stored by the program, the program must have written policies clearly outlining the storing procedure. (5) A program must have written policy and procedure on management of weapons and potential weapons. (6) Guns and ammunition must be kept in locked storage with guns stored separately from the ammunition. Guns kept in vehicles must have a staff member present and be locked in the glove compartment or gun rack, must be unloaded, and ammunition must be kept locked in a separate location in the vehicle. (7) A program participant must have one on one supervision when handling a weapon or gun. (8) Staff shall supervise a program participant's possession and use of knives, hatchets, other edged tools, or any item which may pose a danger to self or others. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.175 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: MONEY AND ADOLESCENT TRAINING AND EMPLOYMENT (1) Money earned or received as a gift or allowance must be part of the program participant's personal property and accounted for separately from the program funds. (2) If the program is partly supported by institutional production on a commercial basis, the program must comply with state and federal child labor and minimum wage laws. (3) For program participants aged 16 and older, a program may assist in: (a) preparing the program participant for economic independence; (b) referring the program participant to the appropriate independent living program if applicable; and (c) obtaining skills necessary for employment as determined to be appropriate to meet the individual's needs. Such skills include: (i) completing applications; (ii) personal appearances for employment situations; (iii) attitudes toward employment; and (iv) interviewing for jobs. (4) A program must distinguish between tasks which program participants are expected to perform as part of living together, jobs to earn spending money, and jobs performed for vocational training. Program participants may not be compelled to work for the program without prior approval of the parent/legal guardian. (5) Program participants may be given age appropriate, non-vocational work assignments within the program participant's capabilities as a constructive experience. The work assignment must comply with all state and federal labor laws, and regulations. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.176 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: RECREATION (1) The program may have an on-grounds recreation program that is operated by the program staff. However, when available, the program must provide the program participant access to community recreation and cultural events when appropriate to the program participant's needs, interests, and abilities. (2) Program participants must have the opportunity to participate in age appropriate recreational activities on a regular basis. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.181 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: INFECTION CONTROL (1) A program must develop and implement an infection prevention and control program. At a minimum the program must develop, implement, and review, at least annually, written policy and procedures regarding infection prevention and control which must include procedures to identify high risk individuals and what methods are used to protect, contain, or minimize the risk to program participants and staff. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.182 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: RELIGION AND CULTURE (1) The program must have written policies and procedures on how the program participant's individual religious and cultural beliefs will be addressed. (2) The program must provide program participants with a reasonable opportunity to practice their respective religions. Program participants must be permitted to have reasonable access to religious materials of their choice. If reasonable access is denied, the program must have documentation of the specific reasons for the denial. (3) The program must document its efforts in providing opportunity and encouragement to each program participant to identify with their cultural heritage. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19. 37.99.183 PRIVATE ALTERNATIVE ADOLESCENT RESIDENTIAL PROGRAMS: TRANSPORTATION (1) All staff transporting program participants must possess a valid driver's license for the type of vehicle used in transporting the program participants. (2) Any person transporting program participants must comply with applicable traffic laws while transporting. (3) All vehicles used in transporting program participants must: (a) have proper Montana registration; (b) have insurance coverage; (c) be maintained in a safe condition; (d) be equipped with a red triangle reflector device for use in an emergency; and (e) be equipped with a first aid kit. (4) The driver and all of the passengers must ride in a vehicle manufactured seat. Each person must use a seat belt. (5) Program participants must not ride in the bed of, or in the back of a truck. (6) Program participants utilizing off highway or all terrain recreational vehicles must wear a helmet and be instructed on safety procedures. Authorizing statute(s): 52-2-803 , 52-2-805 , MCA Implementing statute(s): 52-2-803 , 52-2-805 , 52-2-809 , MCA History: NEW, 2019 MAR p. 2029, Eff. 11/9/19.