NATSAP INSTRUMENTAL IN UTAH REGULATORY CHANGES
Kimball DeLaMare, Island View RTC

The summer of 2004 was a dicey time if you were in the residential treatment business in Utah.  Angry citizens reacting to a tragic death stemming from the aggressive actions of a troubled youth in a program were combining resources with another group of citizens dead set on enacting legislation to keep a sex offender program out of their community.  Certain legislators unfamiliar with our industry were discussing proposals that could severely limit a program’s ability to function while penalizing “good providers” in the interest of safeguarding the public from any who may run more risky enterprises. 

Within the State Office of Licensing there were concerns as to how to interpret regulatory guidelines as programs evolved to better meet client needs.  Behavioral definitions related to what constitutes a “time out”, or other such interventions were open to a variety of interpretations, creating some confusion and risk for providers and consumers.  Although Utah is a noted leader in terms of regulatory oversight, standards were in need of revision, including additional categorical definitions and procedural clarification. 

Independent of each other, several NATSAP programs began to be involved.  From early discussions an ad hoc group hosted first by Provo Canyon School, and subsequently, by the Heritage School banded together to examine issues, develop proposed enhancements to existing standards, and ultimately meet with Licensing Officials to present their findings.  From those workgroups the Office of Licensing, directed by Ken Stettler, was able to advise key legislators, meet with the Attorney General’s office, and ultimately craft legislation that passed into law in the Spring of 2005 and is now developing standards in conjunction with NATSAP and other providers in Utah.   

So what came of all these efforts? 

• NATSAP programs including the Oakley School, Cedar Ridge and Discovery Academy along with Robin Stephens of Aspen Education Group and three other programs have just completed the final drafts of the new Therapeutic Boarding School standards which will allow greater flexibility in step down programming.

• Increased requirements for owner and supervisor competency to safeguard against untrained entrepreneurs attempting to establish substandard programs.

• The option for local communities to employ licensing specialists trained and overseen by the state office, to assure local communities of personal oversight if desired.  Although this provision could be problematic, depending upon how a locality decides to participate, it appears there are sufficient safeguards to restrict reactive or politicized actions on the part of a community.

• A consensus as to how to deal with eighteen year olds who want to remain in settings that typically serve minors without needing formal, individual variance for each and every case.  It appears that programs will first submit specific procedures as to housing, assurance of rights, programming, and other concerns related to the continued stay of eighteen year olds and these will be audited annually once approved.

• Adoption of behavioral management definitions and policies as provided to the state by NATSAP.  These procedural guidelines were initially authored by Jared Balmer of Island View who also sits on the national advisory board of the Joint Commission on Accreditation of Health Care Facilities (JCAHO).  These guidelines were subsequently approved by NATSAP membership after board review.  They will greatly aid in the prevention of abusive and punitive practices that compromise treatment and prejudice the public.

• The installation of Jeff Smith of Logan River Academy on the Licensing Review Board as an industry representative.  Jeff is also heading up the Utah Region of NATSAP which is the first local region to formally organize.

Although there is more to come we are excited by the collaborative relationships NATSAP has been able to develop with the state.  We look forward to further enhancements of state policies and guidelines to protect the public while delivering effective care. 

Note:  Kimball DeLaMare, past president of NATSAP was instrumental in coordinating NATSAP efforts related to the proceeding article.  He notes that a majority of the Utah members of NATSAP were involved in this remarkable process.