(d) To admit
a child for treatment as a resident, a residential psychiatric treatment center
must document that
(1) other care or treatment
resources available in the community or region do not meet the treatment needs
of the child because the other care or treatment resources are
(A) more restrictive or less restrictive than
necessary to appropriately treat the child; or
(B) provided in a setting less restrictive
than the facility, but the child's treatment history shows that when
therapeutic services in less restrictive settings have been provided to the
child the services have been ineffective;
(2) proper treatment of the child's
psychiatric condition requires treatment and services on an inpatient
residential basis under the direction of a physician because the child
(A) has a psychiatric condition or disorder
that meets the diagnostic criteria as set out in the American Psychiatric
Association's
Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition (DSM-5), adopted by reference as amended from
time to time;
(i) classified as a DSM-IV Axis
I diagnosis as set out in the American Psychiatric Association's
Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition, Text Revision, 2000 (DSM-IV-TR), as amended from time to time; the
provisions of that Axis are adopted by reference; or
(ii) indicated by a rating on the DSM-IV Axis
V of GAF equal to 50 or less, or has an Axis V GAF rating of more than 50 but
exhibits one or more specific mental, behavioral, or emotional disorders that
place the child at imminent risk for out-of-home supervision or protective
custody by state or local authorities; for purposes of this sub-subparagraph,
"GAF" means the Global Assessment of Functioning assessment instrument
published in the American Psychiatric Association's Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition, Text Revision,
2000 (DSM-IV-TR), as amended from time to time; that assessment instrument is
adopted by reference;
(B) requires the intensity of services
available at a residential psychiatric treatment center, as documented by the
clinical director of the facility, specifically including the following needs:
(i) a need for treatment services to be
supervised by a psychiatrist;
(ii)
a need for mental health professionals to be available to intervene with the
child 24 hours a day;
(iii) a need
for the child to concurrently receive multiple therapies;
(C) does not demonstrate mental, emotional,
or behavioral dysfunction that requires acute psychiatric hospitalization, such
as a serious gesture or an actual attempt at suicide; and
(D) does not demonstrate actual behavior of
assaults or escalation towards assault that cannot be managed at the level of
care available in the facility; and
(3) the services provided by the facility can
reasonably be expected to improve the child's condition or to prevent further
regression so that services of a residential psychiatric treatment center will
no longer be needed.
