Psychiatric Residential Treatment Facilities: New Mental Health - - PowerPoint PPT Presentation

Psychiatric Residential Treatment Facilities:

New Mental Health Treatment for Minnesota’s Youth

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

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.

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

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)

Residential Treatment Center vs PRTF

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

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

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

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

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

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

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

Cambia Hills Stakeholder Summary

91% 9%

Do you see a need for a PRTF?

Yes No

Cambia Hills Stakeholder Summary

91% 82% 82% 73% 73% 64% 64% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Post Traumatic Stress Disorder Addictions Depression Fetal Alcohol Syndrome Impulse Control Disorder Anxiety Disorders Bipolar Disorders

A PRTF is needed to serve youth with: *Only those 60% or higher were reported

Cambia Hills Stakeholder Summary

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Physical Exercise Family Programming Integrated Educational Services Having Time Outdoors Community Outings

100% 91% 91% 82% 36% 0% 9% 9% 18% 55%

How important are the following features in a PRTF

Very Important Important

Cambia Hills Stakeholder Summary

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 91% 82% 73% 73% 73% 64% 27% 36% 73% 9% 18% 27% 27% 27% 36% 64% 64% 27%

How important are the following treatment modalities: *only those with 60% or higher for very important or important

Very Important Important

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

Cambia Hills – East Bethel PRTF Aerial View

Cambia Hills – East Bethel PRTF Exterior View

Cambia Hills – East Bethel PRTF Lobby

Cambia Hills – East Bethel PRTF Bedroom

Cambia Hills – East Bethel PRTF Classroom

Cambia Hills – East Bethel PRTF Gym

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

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

Cambia Hills Target Population Discussion

Children ages 7 to 17 Moderate to severe mental disorders Mild neurodevelopment disorders Mild neurocognitive disorders

Service Activities

 Diagnostic Assessment  Individual Care Plan

Development

 Medication Management  24-Hour Nursing Service  Neuropsychological Testing  Educational Services

Coordination

 Discharge and Transition

Planning

 Therapeutic Recreational

Activities

 Individual Therapy  Family Therapy  Community Consultations  Health Activities  Parent

Engagement/Enrichment

 Seclusion/Restraint Capability

Cambia Hills Treatment Approach

Provide a safe, supportive, and fun environment Relationships are key – the key vehicle of change Trauma-Informed clinical interventions and

• rganizational framework

Education services – integrated and seamless

Cambia Hills Treatment Approach

Culturally responsive Families important members of treatment team Comprehensive transition planning Developmentally appropriate

Therapeutic Recreational Activities

Animal Husbandry Arts Recreational Sports Therapeutic Gardening Community Outings

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.

Education Services: Intermediate School District 916

Teaching at Northeast Metro 916

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 students and families we collectively support. How we benefit member districts:

• Innovative and quality educational options not available, or limited,

in member districts.

• High staff retention resulting in consistent and reliable

learning environments.

• Programs created and delivered in partnership with members.
• Educational options that provide a high return on investment.

Our 1 r 10 M Member D r Distri tricts ts:

• Centennial #12
• Columbia Heights #13
• Mahtomedi #832
• Mounds View # 621
• North St. Paul-Maplewood-

Oakdale #622

• Roseville #623
• South Washington County

#833

• Spring Lake Park #16
• Stillwater Area #834
• White Bear Lake #624

Special Education Services For students ages 2 to 21 years old

Provided 4 Ways:

 Center Based – Federal Setting IV

 Referral Only

 Contracted to Local Districts  At treatment Centers – education service

(residential and day treatment) District 916 Unique Services:

 Project Return (Alternative to

suspension/expulsion)

 Assessment Center (comprehensive

educational and mental health evaluations)

 Assistive Tech Assessment Team  Consultation Team-contracts with local

districts to provide on-site consultation for districts specific needs

District 916 Specialties

▪ Communication Interactional Disorders (ASD) ▪ Severely Multiply Impaired ▪ High needs behavior – turning it around ▪ Mental illness overlays -partnership with Canvas Health and Child Therapeutic Support Services (CTSS) level II certified ▪ Vocational Education/Work Experience ▪ Audiological and DHH services

Overview of Special Education Programs

Education

Learning/Teaching Curriculum Place-based Trauma-Informed school

.

Compassionate School Philosophy

Trauma Informed practices

Remove barriers to learning Seek to understand and support Build caring relationships Focus on academic and non-academic areas

How We Teach

 Empowerment  Positive Regard  High Expectations  Informed Decisions  Relationships  Guided Opportunities

Focus Areas in a Compassionate School

Safety Connection/Assurance of Well-being Emotional + Behavioral/Self-regulation Competencies of personal agency, social skills and academics

QUESTIONS?