R501. Health and Human Services, Human Services Program Licensing.

R501-15. Therapeutic Schools.

R501-15-1. Authority and Purpose.

(1) Section 26B-2-104 authorizes this rule and establishes basic health and safety standards for therapeutic schools.

(2) This rule supplements the general provisions required of each human services program in Rule R501-1.

R501-15-2. Scope.

(1) Each therapeutic school provider shall comply with this rule and Rules R501-1, and R501-14.

(2) Before offering any residential treatment services, each therapeutic school shall comply with Rule R501-19 and obtain a residential treatment license.

R501-15-3. Definitions.

The terms used in this rule are defined in Sections 26B-2-101 and R501-1-3.

R501-15-4. Administration.

(1) Each therapeutic school provider shall develop, maintain, and follow a current policy and procedure manual, that includes:

(a) a requirement that a client may not attend a therapeutic school unless the school receives a certificate of immunization for the client from a licensed physician or an authorized representative of the state or local health department stating that the client has received immunization in accordance with Rule R396-100;

(b) a procedure for quarterly evaluation and assessment of the needs of each client;

(c) an emergency transportation plan describing how the therapeutic school provider will safely transport each client to the client's legal guardian within 48 hours once the plan has been initiated;

(d) a detailed description of the therapeutic school's client admission, exclusion, and expulsion criteria and procedures;

(e) a requirement that the therapeutic school provider may not admit or provide services to an individual who:

(i) within the past two years, has attempted suicide or made serious self-harm gestures requiring medical or therapeutic treatment;

(ii) has a mental health diagnosis of psychosis, schizophrenia, severe depression, mental retardation, or a severe mental illness requiring medical or therapeutic treatment;

(iii) is violent, highly combative, or physically or sexually aggressive;

(iv) presents substantial security risks;

(v) requires medical detoxification;

(vi) lacks the ability to engage in a rational decision-making process or exhibits severely impaired judgment; or

(vii) has a history of repeated runaway attempts or incidents; and

(f) a requirement that the school shall expel a client who exhibits high-risk behavior or conditions, including a client who:

(i) attempts suicide or makes serious self-harm gestures requiring medical or therapeutic treatment;

(ii) has a psychosis, schizophrenia, severe depression, mental retardation, or a severe mental illness requiring medical or therapeutic treatment;

(iii) is violent, highly combative, or physically or sexually aggressive;

(iv) presents substantial security risks;

(v) requires medical detoxification;

(vi) lacks the ability to engage in a rational decision-making process or exhibits severely impaired judgment;

(vii) runs away or has attempted to run away more than two times;

(viii) uses or attempts to use illegal substances more than two times; or

(ix) exhibits any other behavioral or emotional conditions that require more intense supervision and treatment than that permitted in a therapeutic school.

(2) Each therapeutic school provider's policy and procedure manual shall outline the provider's:

(a) academic accreditation or disclosure that the school is not accredited;

(b) curriculum;

(d) policy on grading, progress assessment, and testing;

(e) academic and career counseling;

(f) academic activities;

(g) graduation requirements;

(h) post-graduation planning service;

(i) method of providing on-site specialized structure and supervision;

(j) methods for providing off-site specialized structure and supervision;

(k) policy for services and treatment for managing a client's:

(i) disability;

(ii) emotional development;

(iii) behavioral development;

(iv) familial development; and

(v) social development;

(l) behavior management practice;

(m) individual, group, or family counseling service;

(n) school rules;

(o) food service policy and weekly menu;

(p) physical education and recreational activity policy;

(q) client rights statement;

(r) policy regarding permitted and prohibited items and dangerous weapons that:

(i) is developed in consideration of the age and behavioral characteristics of the client population the program serves; and

(ii) describes how dangerous weapons are stored and any circumstances when they may be accessible to a client;

(s) client grievance policy and appeal process for the grievance policy; and

(t) contact information for the office of licensing.

(3) Each therapeutic school provider shall provide the client manual described in this section to each client and each client's legal guardian before the therapeutic school provider may accept any payment or process any application to provide services.

R501-15-5. Financial Requirements.

(1) Each therapeutic school provider shall provide an itemized accounting of expenditures made on behalf of a client before requiring reimbursement from the client's guardian.

(2) Each therapeutic school provider shall maintain an accurate log of each fund deposited and each withdrawal made for the personal use of each client.

R501-15-6. Staff Requirements.

(1) Each owner and board member of a therapeutic school shall successfully complete a minimum of eight hours of annual training relating to therapeutic school services.

(2) Each therapeutic school provider shall ensure a therapeutic director or equally qualified acting director is immediately available to staff by telephone and able to arrive on-site within one hour after a staff telephone call for assistance.

(3) Each therapeutic school provider shall ensure the therapeutic director or qualified acting director:

(a) is at least 25 years of age;

(b) has a bachelor's degree in social work or a related field, or a minimum of three years of documented training or experience in providing therapeutic school or residential treatment services; and

(4) Each therapeutic school provider shall ensure there is at least one direct care supervisor or supervisor designee on duty at all times.

(5) Each therapeutic school provider shall ensure supervisor or supervisor designee:

(a) has a minimum of six months of experience providing services to children in out-of-home placements; and

(b) meets each qualification, including requirements for education, experience, licensing or certification, and current annual continuing education and training directly related to providing:

(i) specialized structure and supervision of clients; and

(ii) services or treatment related to a client's disability, emotional development, behavioral development, familial development, or social development.

(6) Each therapeutic school provider shall maintain a staff manual that includes:

(a) specific job descriptions for each staff position;

(b) staff qualifications for each staff position, including requirements for education, experience, and licensing or certification;

(d) the required training for staff who will work with clients with a history of failing to function at home or school.

(7) Each therapeutic school provider shall ensure at least two direct care staff are on duty to provide direct supervision to clients at all times.

(8)(a) Each therapeutic school provider shall ensure that each client who has earned the privilege of unsupervised time off-site engages in two-way communication with on-duty direct care staff once every four hours.

(b) Each therapeutic school provider shall develop and adhere to a policy that outlines steps for staff to take if a client fails to check in with staff once every four hours.

(9) Each therapeutic school provider may not include support staff in the minimum staff-to-client ratios.

(10)(a) Each therapeutic school provider shall ensure the following minimum waking hour staff-to-client ratios are followed:

(i) two direct care, on-duty staff for eight or fewer clients present;

(ii) three direct care, on-duty staff for nine to 24 clients present;

(iii) four direct care, on-duty staff for 45 to 48 clients present;

(iv) five direct care, on-duty staff for 49 to 96 clients present; and

(v) six direct care, on-duty staff for more than 97 clients present with a ratio of no less than one direct care, on-duty staff for every 20 clients present.

(b) Each therapeutic school provider shall comply with waking hour direct care staff-to-client ratios listed in this subsection unless authorized by the office to modify the required ratios.

(11)(a) Each therapeutic school provider shall ensure the following minimum sleeping hour staff-to-client ratios are followed:

(i) two direct care, on-duty staff for 48 clients present; and

(ii) three direct care, on-duty staff for 49 or more clients present with no less than one direct care, on-duty staff for every 40 clients present.

(b) Each therapeutic school provider shall comply with sleeping hour direct care staff-to-client ratios listed in this subsection unless authorized by the office to modify the required ratios.

R501-15-7. Client Services.

(1) Each therapeutic school provider shall ensure each service plan includes a quarterly assessment of the effectiveness of the therapeutic school's policy, procedure, and practice in meeting each client's needs.

(2) Each therapeutic school provider shall provide each client's legal guardian with a copy of each service plan within two weeks after the service plan is developed or updated.

(3) Each therapeutic school provider that must travel more than 30 miles to an emergency room or 24-hour urgent care facility shall ensure a medical practitioner and a licensed mental health therapist are on-call to the program.

(4) Upon admission, each therapeutic school provider shall inform each client of the right to consult with a medical practitioner or a licensed mental health therapist.

(5)(a) Each client shall receive an immediate medical assessment by a certified wilderness responder, certified EMT or medical practitioner for the following:

(i) a serious illness;

(ii) a serious injury; or

(iii) upon client request to see a medical practitioner.

(b) Each therapeutic school provider shall attach the medical assessment documentation to an incident report.

(6) Each therapeutic school provider shall post each monthly schedule of activities in the common area and in the office and retain each activity schedule for at least one year.

(7) Each therapeutic school provider's academic curriculum shall receive accreditation by an entity recognized by the Utah State Board of Education, or the school shall present an educational service plan and educational funding plan in accordance with Section 26B-2-116.

(8) Each therapeutic school provider shall provide the school's curriculum to each client and the client's legal guardian before accepting any payment or processing any application to provide services.

(9) Each therapeutic school provider shall review and update the school's curriculum annually.

(10) Each therapeutic school provider shall provide any modifications to the curriculum to each client and the client's legal guardian within two weeks of any curriculum change.

(11) Each therapeutic school provider shall monitor and document each client's academic progress and communicate the progress to the client's legal guardian each month.

R501-15-8. Physical Environment.

(1) Each therapeutic school provider shall provide indoor common areas for group activities, that may include a gymnasium, recreation area, cafeteria, classrooms, library, and lounge.

(2) Each therapeutic school provider shall comply with the following regarding the physical aspects of the facility:

(a) each common area space contains at least 30 square feet per client;

(b) there are at least three feet between beds and two feet at the end of each bed;

(d) each multiple-occupant bedroom contains at least 50 square feet per client, and each single occupant bedroom contains at least 80 square feet per client, excluding storage space; and

(e) each client has at least 30 cubic feet of private storage space.

(3) Each therapeutic school provider shall provide a school desk or table, light, and chair for each client.

R501-15-9. Penalties.

Any person found in noncompliance with any provision of this rule may be subject to the penalties enumerated in Section 26B-2-208 and Rule R380-600.

KEY: human services, therapeutic schools

Date of Last Change: April 15, 2024

Notice of Continuation: November 13, 2025

Authorizing, and Implemented or Interpreted Law: 26B-2-104