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Psychiatric Residential Treatment Facilities: New Mental Health Treatment for Minnesotas Youth Introductions Dave Hartford PRTF Administrator, Cambia Hills East Bethel, The Hills Youth and Family Services Tammy Bednar Principal,


  1. Psychiatric Residential Treatment Facilities: New Mental Health Treatment for Minnesota’s Youth

  2. Introductions  Dave Hartford PRTF Administrator, Cambia Hills – East Bethel, The Hills Youth and Family Services  Tammy Bednar Principal, Cambia Hills – East Bethel, Northeast Metro 916 Intermediate School District

  3. What is a Psychiatric Residential Treatment Facility?  Centers for Medicare and Medicaid defines PRTF as a separate, stand-alone entity providing a range of comprehensive services to treat the psychiatric condition of residents on an inpatient basis under the direction of a physician: the purpose of the service is to improve the resident’s condition or prevent further regression so that services are no longer needed.

  4. Characteristics of a PRTF  Inpatient Facility  Serves individuals ages 21 and under  A level of care utilized when:  Ambulatory care services in the community do not meet the needs of the youth  The individual requires 24-hour care with nursing under the direction of a physician  Services are reasonably expected to improve the condition or prevent further regression

  5. Why did Minnesota need PRTF’s?  Over 300 children sent out of the state every year  More intense level of service than Residential Treatment Center  Less intensive level of service than inpatient  Minnesota Children’s Residential Treatment Centers declared IMD’s (Institutes of Mental Disease)

  6. Residential Treatment Center vs PRTF  Residential Treatment Center (RTC) – Rehabilitative Service  PRTF – Active Treatment

  7. Legislation that Authorized Minnesota’s PRTF’s  Passed in 2015  Authorized 150 beds in up to 6 sites  50 beds by end of 2017  $6.616 million was appropriated for PRTFs and for the contract beds  Difference from RTCs  Not considered an IMD  Payment includes room and board  No need for voluntary placement agreement with county  Legislative proposals and regulatory changes

  8. NAMI-MN Focus Group and Survey Data  NAMI PRTF Family Survey results  Identified areas of importance that included physical surroundings, activities, family connections, treatment modalities, staffing, transition planning, and meals

  9. NAMI Survey Recommendations  Physical Surroundings – soothing environment, warm colors, natural lighting, open space with flexible seating, comfortable furnishings, and private meeting space for families  Activities – provide a variety of physical activities, access to a quality education, different therapy approaches, such as art therapy, music therapy, and pet therapy, ways to help others, yoga, and meditation  Family – support groups for family, frequent communication on treatment progress, and a family visiting space

  10. NAMI Survey Recommendations cont.  Staffing – well trained and educated, trauma trained and adequate staffing, family peer specialists  Transition – create a detailed transition plan that connects youth back to the community with resources for education, appointments and support  Food – provide nutritious meals with quality options for those with dietary restrictions. Educate on the importance of fueling the body with the right foods

  11. NAMI Survey Comments  Allow connection to friends and unlimited access to families – don’t isolate them from their community  Variable or open visiting hours to make it easier to see people  Greater connection by phone/text

  12. NAMI Survey Comments cont.  Being included in the discharge process from the beginning  Include the school district in the discharge planning  Checking on client and family after being discharged  Ensuring aftercare is set up before discharge

  13. Cambia Hills Stakeholder Summary Do you see a need for a PRTF? 9% 91% Yes No

  14. Cambia Hills Stakeholder Summary A PRTF is needed to serve youth with: *Only those 60% or higher were reported 100% 91% 90% 82% 82% 80% 73% 73% 70% 64% 64% 60% 50% 40% 30% 20% 10% 0% Post Addictions Depression Fetal Alcohol Impulse Anxiety Bipolar Traumatic Syndrome Control Disorders Disorders Stress Disorder Disorder

  15. Cambia Hills Stakeholder Summary How important are the following features in a PRTF 0% 100% 9% 9% 18% 90% 80% 70% 55% 60% 100% 50% 91% 91% 82% 40% 30% 36% 20% 10% 0% Physical Exercise Family Integrated Having Time Community Programming Educational Outdoors Outings Services Very Important Important

  16. Cambia Hills Stakeholder Summary How important are the following treatment modalities: *only those with 60% or higher for very important or important 100% 9% 18% 90% 27% 27% 27% 27% 36% 80% 64% 70% 64% 60% 50% 91% 82% 40% 73% 73% 73% 73% 64% 30% 36% 20% 27% 10% 0% Very Important Important

  17. *Keep ep? Cambia Hills – East Bethel PRTF Floor Plan

  18. Cambia Hills – East Bethel PRTF Aerial View

  19. Cambia Hills – East Bethel PRTF Exterior View

  20. Cambia Hills – East Bethel PRTF Lobby

  21. Cambia Hills – East Bethel PRTF Bedroom

  22. Cambia Hills – East Bethel PRTF Classroom

  23. Cambia Hills – East Bethel PRTF Gym

  24. Regulatory Framework  Minnesota Department of Health  Medicaid Certified Psychiatric Residential Treatment Facility  Licensed Supervised Living Facility  Minnesota Department of Human Services  Licensed Children’s Residential Treatment Facility (Rules Chapter 2960)  PRTF Variance to Rule 2960  Joint Commission or the Council on Accreditation (COA) Certification

  25. Admission Criteria  Mental health diagnosis as defined in most recent DSM  Clinical evidence that the child is at risk to self or others  Functional impairment and a history of difficulty functioning safely in the community, schools, home, or job; inability to adequately care for one’s physical needs; caregivers or family members are unable to fulfill the child’s needs  Required to improve the child’s condition or prevent regression  Community based services have been exhausted and/or cannot provide the level of care needed

  26. Cambia Hills Target Population Discussion  Children ages 7 to 17  Moderate to severe mental disorders  Mild neurodevelopment disorders  Mild neurocognitive disorders

  27. Service Activities  Diagnostic Assessment  Therapeutic Recreational Activities  Individual Care Plan Development  Individual Therapy  Medication Management  Family Therapy  24-Hour Nursing Service  Community Consultations  Neuropsychological Testing  Health Activities  Educational Services  Parent Coordination Engagement/Enrichment  Discharge and Transition  Seclusion/Restraint Capability Planning

  28. Cambia Hills Treatment Approach  Provide a safe, supportive, and fun environment  Relationships are key – the key vehicle of change  Trauma-Informed clinical interventions and organizational framework  Education services – integrated and seamless

  29. Cambia Hills Treatment Approach  Culturally responsive  Families important members of treatment team  Comprehensive transition planning  Developmentally appropriate

  30. Therapeutic Recreational Activities  Animal Husbandry  Arts  Recreational Sports  Therapeutic Gardening  Community Outings

  31. Education Services: Intermediate School District 916  Intermediate districts are specialty school districts that provide defined shared student services to a group of K-12 “member” school districts.  Minnesota has three intermediate school districts.  Combined, the three districts serve more than 18,000 students across 31 member districts.  Intermediates offer specialized educational programs and services to member districts that, individually, find it difficult to provide on a smaller scale.

  32. Education Services: Intermediate School District 916 Teaching at Northeast Metro 916

  33. Partners in Education Through the of sharing of resources, talent and ideas, District 916 provides cost-effective, specialized and reliable services to member districts and the Our 1 r 10 M Member D r Distri tricts ts: • Centennial #12 students and families we collectively support. • Columbia Heights #13 • Mahtomedi #832 • Mounds View # 621 How we benefit member districts: North St. Paul-Maplewood- • Oakdale #622 • Innovative and quality educational options not available, or limited, • Roseville #623 in member districts. • South Washington County #833 • High staff retention resulting in consistent and reliable Spring Lake Park #16 • learning environments. • Stillwater Area #834 • Programs created and delivered in partnership with members. • White Bear Lake #624 • Educational options that provide a high return on investment.

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