Current through Register Vol. 50, No. 9, September 20, 2024
A. The PRTF shall have an on-going plan,
consistent with available community and PRTF resources, to provide medical,
dental, therapeutic, social, psychological, recreational, rehabilitative and
educational services to meet the medically related needs of its
residents.
B. Arrangement of
Residents into Groups
1. The provider shall
arrange residents into groups that effectively address the needs of the
residents.
2. All residents shall
have an opportunity to build relationships within small groups.
3. Residents shall be involved in decision
making regarding the roles and routines of their living group to the degree
possible considering their level of functioning.
4. No more than 15 residents shall be in a
group or unit.
5. The PRTF shall
have a distinct unit for minors.
6.
Groups shall be separated by gender.
C. The services provided by the PRTF must
involve active treatment.
1. The team of
professionals who shall develop the comprehensive plan of care shall be
composed of physician(s) and other personnel who are employed by, or who
provide services to the recipient in the facility. The team shall be capable of
assessing the residents immediate and long-range therapeutic needs, personal
strengths and liabilities, potential resources of the residents family, capable
of setting treatment objectives, and prescribing therapeutic modalities to
achieve the plan's objectives. The team shall include, at a minimum, either:
a. a board-certified or board-eligible
psychiatrist; or
b. a licensed
clinical psychologist who has a doctorate degree and a physician licensed to
practice medicine or osteopathy; or
c. a physician licensed to practice medicine
or osteopathy with specialized training and experience in the diagnosis and
treatment of mental diseases and a psychologist who has a master's degree in
clinical psychology.
2.
The team shall also include one of the following:
a. a psychiatric social worker;
b. a registered nurse with specialized
training or one year of experience in treating individuals with mental
illness;
c. a licensed occupational
therapist with specialized training, or one year of experience in treating
individuals with mental illness; or
d. a psychologist who has a master's degree
in clinical psychology or who is licensed pursuant to
R.S.
37:2351 et seq. or is a licensed medical
psychologist pursuant to
R.S.
37:1360.51.
3. The comprehensive plan of care is a
written plan developed for each recipient to improve the recipients condition
to the extent that inpatient care is no longer necessary. The plan shall:
a. be based on a diagnostic evaluation that
includes examination of the medical, psychosocial, social, behavioral, and
developmental aspects of the recipient's situation and reflects the need for
PRTF services, including:
i. diagnoses,
symptoms, complaints, and complications indicating the need for
admission;
ii. a description of the
functional level of the individual;
iii. any orders for medication and
diet;
iv. restorative, social, and
rehabilitation services;
v.
treatment objectives;
vi. an
integrated program of therapies, activities, and experiences designed to meet
the objectives;
vii. plans for
continued care, as appropriate; and
viii. post-discharge plans and coordination
of inpatient services with partial discharge plans and related community
services to ensure continuity of care with the recipient's family, school, and
community upon discharge;
b. be developed and implemented no later than
14 days after the recipient's admission; and
c. be designed to achieve the recipient's
discharge at the earliest possible time.
4. The plan shall be reviewed as needed, but
at a minimum of every 30 days by the facility treatment team to determine that
services being provided are, or were, required on an inpatient basis and
recommend changes in the plan as indicated by the recipients overall adjustment
as an inpatient.
D. The
provider shall ensure that any provider of professional or special services
(internal or external to the agency) meets the following:
1. The program shall be appropriate to the
needs and interests of residents and be directed toward restoring and
maintaining optimal levels of physical and psychosocial functioning.
2. have adequate space, facilities and
privacy;
3. have appropriate
equipment;
4. have adequate
supplies;
5. have appropriate
resources.
E. The PRTF
shall also have an effective, on-going discharge planning program that
facilitates the provision of follow-up care. The plan of care shall include, at
an appropriate time, post-discharge plans and coordination of inpatient
services, with partial discharge plans and related community services to ensure
continuity of care with the recipient's family, school and community upon
discharge. Each resident's record shall be annotated with a note regarding the
nature of post PRTF care arrangements. Discharge planning shall be initiated in
a timely manner. Residents, along with necessary medical information (e.g., the
resident's functional capacity, nursing and other care requirements, discharge
summary, referral forms) shall be transferred or referred to appropriate
facilities, agencies or services, as needed, for follow-up or ancillary
care.
F. The PRTF shall provide or
have available a therapeutic activities program.
1. The program must be appropriate to the
needs and interests of patients and be directed toward restoring and
maintaining optimal levels of physical and psychosocial functioning.
2. The number of qualified therapists,
support personnel and consultants shall be adequate to provide comprehensive
therapeutic activities consistent with each patient's treatment plan.
G. The provider shall have a
written plan for insuring that a range of indoor and outdoor recreational and
social opportunities are provided for residents. Such opportunities shall be
based on both the individual interests and needs of the resident and the
composition of the living group.
1. The
provider shall be adequately staffed and have appropriate recreation spaces and
facilities accessible to residents.
2. Any restrictions of recreational and
social opportunities shall be specifically described in the treatment plan,
together with the reasons such restrictions are necessary and the extent and
duration of such restrictions.
3.
The PRTF shall provide a minimum of three hours per week of social and/or
recreational activities.
H. The provider shall have a program to
ensure that residents receive training in independent living skills appropriate
to their age and functioning level. This program shall include instruction in:
1. hygiene and grooming;
2. laundry and maintenance of
clothing;
3. appropriate social
skills;
4. housekeeping;
5. budgeting and shopping;
6. cooking; and
7. punctuality, attendance and other
employment-related matters.
I. Each resident shall have a minimum of one
face-to-face contact with a psychiatrist each month and additional contacts for
individuals from special risk populations, and as clinical needs of the
resident dictate.
J. The services
of qualified professionals and specialists from the following areas shall be
provided by and in the PRTF when necessary to meet the needs of the residents:
1. medicine and dentistry;
2. nursing;
3. speech, occupational, and physical
therapies;
4. psychology and
psychiatry;
5. social
work;
6. laboratory and
diagnostic/radiology services;
7.
optometry or ophthalmology; and
8.
pharmacy activities.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
36:254 and
R.S.
40:2009.
