Ohio Admin. Code 5122-41-02 - Psychiatric residential treatment facility model
(A)
Psychiatric
residential treatment facility (PRTF) is a trauma informed, inpatient level,
intensive multi-disciplinary residential treatment provided in a non-acute
setting for youth with complex needs. A PRTF delivers trauma-informed,
evidence-based individualized services to youth in order to stabilize behaviors
in as short as possible time frame, and help youth and their family or
caregiver to develop the knowledge and skills needed to safely manage their
needs in the community, so that the youth can succeed in all aspects of
community living, e.g. home and family, school, employment,
etc.
(B)
Individuals referred to PRTF programs are youth with
complex needs including significant behavioral challenges. These individuals
have a mental health diagnosis or co-occurring mental health and other
diagnosis, e.g. substance use, intellectual disability, and at least one of the
following:
(1)
Exhibiting severe mental health symptoms at the time of the
referral to PRTF.
(2)
Documented severe functional impairment in comparison
to same age peers or same developmental age peers in multiple life domains
(school performance, family relationships, interpersonal relations,
communication/thought processes, self-care, and community) as reflected in the
most recent Ohio children's initiative child and adolescent needs and strengths
(CANS) assessment and other clinical documentation. If an Ohio children's
initiative CANS assessment has not been completed or did not result in a
recommendation of PRTF, clinical documentation indicating severe functional
impairment may be used.
(C)
PRTF model
description.
(1)
Provided seven days a week to youth.
(2)
Physician
directed.
(3)
Multi-disciplinary.
(4)
Treatment is
focused on the objectives that are most important for the youth to address to
achieve a successful transition to their community.
(5)
Able to address
the intensive treatment, supervision, and safety needs of the
youth.
(6)
Possess the capacity and expertise to provide targeted
treatment services to address the variety of needs of the
youth.
(7)
Treatment is strength-based, individualized, and the
quantity and frequency of services is adjusted based upon the needs of
individuals and the culture of the milieu.
(8)
Have sensory
regulation items and equipment available for youths as needed.
(9)
Inclusive of
evidence-based treatment services that focus on the strengths of the youth and
their family or caregiver.
(10)
Have qualified
staff who are Ohio children's initiative CANS certified assessors, who will
conduct the follow-up CANS when other appropriate entities (care management
entities, community behavioral health centers, etc.) have not conducted the
CANS.
(11)
Consists of appropriate therapeutic, educational,
recreational, and medical services, including referral and transportation to
services that are not provided by the PRTF.
(12)
Available to the
youth and family or caregiver post transition.
(13)
Utilizes
performance improvement processes to monitor performance, address problem areas
and troubleshoot, and assure provision of quality services.
(14)
Facilitate
continued OhioRISE care coordination (including in person visits and
facilitating CANS assessments by the OhioRISE care coordinator) throughout
treatment and the PRTF will participate in the OhioRISE child and family
team.
(D)
A PRTF is inpatient level of care provided in a
non-acute home-like environment.
(1)
The PRTF will be in either:
(a)
A separate,
free-standing building; or,
(b)
In a building
with other services, which may include a class one residential facility,
however the PRTF will be located on a separate floor or in a separate unit or
wing. There may be only incidental interaction between youths in the PRTF and
the class one residential facility residents who are not in the PRTF when
clinically appropriate.
(2)
The PRTF will
provide to each youth a bedroom of not more than a double occupancy while
meeting all other standards regarding sleeping space in rule
5122-30-14 of the Administrative
Code. In PRTFs serving youth with cooccurring behavioral health and
intellectual or developmental disabilities each bedroom will be single
occupancy.
(3)
The PRTF will respect as much as possible the youth's
choice regarding services and supports, and who provides them.
(4)
The PRTF will
allow the youth to have input into the choice of schedule and activities, and
food options as clinically appropriate.
(5)
The PRTF will
allow the youth freedom to furnish and decorate their sleeping and living areas
as much as possible while being consistent with considerations for the health
and safety of the youth.
(6)
The PRTF will meet the following for the living and
dining space of the facility in addition to the standards in rule
5122-30-14 of the Administrative
Code:
(a)
Have a
meeting space that is large enough to accommodate all youths at the same
time;
(b)
Have a communal area that provides space and
opportunities for small group activities and socializing; and,
(c)
Have
entertainment or recreational areas, including furnishings, that promote social
engagement.
(7)
Notwithstanding paragraph (T) of rule
5122-30-12 of the Administrative
Code, a PRTF may restrict youth's ability to leave the facility by means of
locked doors. If a PRTF locks doors on the facility or unit within the
facility, then all lockable doors will have delayed egress locks in accordance
with the Ohio building code. Staff will also be immediately available on the
premises to open the door for any youth. Doors will be operable from the
outside by local fire departments via a fire department access box or
key.
(E)
The PRTF treatment environment:
(1)
Utilizes a
trauma-informed treatment model that is approved by the department for the
population the PRTF serves. A trauma-informed treatment model is a program,
organization or system that:
(a)
Realizes the widespread impact of trauma and
understands potential paths for recovery;
(b)
Recognizes the
signs and symptoms of trauma in clients, families, staff and others involved
with the system;
(c)
Responds by fully integrating information about trauma
into policies, procedures and practices;
(d)
Seeks to actively
resist re-traumatization; and,
(e)
Includes service
of clinical needs and:
(i)
Is an approved trauma informed treatment model
applicable to the population of youth served located at
http://jfs.ohio.gov/ocf/Family-First.stm
; or,
(ii)
Meets the ten substance abuse and mental health
services administration (SAMHSA) implementation domains and follows the six key
principles of the SAMHSA trauma informed approach which are located at
http://jfs.ohio.gov/ocf/Family-First.stm
.
(2)
Reduces and
avoids re-traumatization that can occur in a residential treatment
environment.
(3)
Is nurturing, non-coercive, family-friendly, and
provides for normalcy and consistency. The PRTF does not use punitive systems,
e.g. a level system where a youth may lose an earned level.
(4)
Focuses on
assisting youth with self-regulation.
(5)
Utilizes
trauma-informed strategies around safety as part of engagement, including
developing soothing plans for each youth, as well as incorporating other
strategies and tools such as making available the use of sensory items for a
youth.
(6)
Utilizes staff that can recognize crisis triggers
during treatment, assist the youth if needed with implementing individual
soothing plans, and engage with the youth to prevent the escalation of
behaviors.
(7)
Is culturally, linguistically, and developmentally
appropriate for the youths served.
(8)
Includes a
sensory room will be available to the youth.
Notes
Promulgated Under: 119.03
Statutory Authority: 5119.141
Rule Amplifies: 5119.141, 5119.34
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