Latest Requirements for Residential Treatment Centers

Residential treatment is a time-limited mental health service provided in a residential setting. Teens or young adults at residential treatment centers are in need of structure and assistance from full time RTC and mental health staff. Further these teens are at risk of significant functional deterioration if they do not receive these services. Residential treatment centers are designed to develop and enhance the following:

  • Psychiatric stability
  • Personal and emotional adjustment
  • Self-sufficiency
  • Skills to live in a more independent setting

Residential Treatment Centers are managed to a earmarked discharge date with specified outcomes for the teen in question. In addition, the RTC treatment and practices must be consistent with evidence-based applications.

Eligible RTC Providers

  • An Residential Treatment Facility must comply with the following:
  • Be licensed with the Rule 36 Variance.

Note: the Rule 36 Variance ensures health and safety of persons receiving services; and developing policy and procedures for the Residential Treatment Center’s programs.

  • Have a contract with the host county agency, which approves the IRTS service
  • Have a rate approved by DHS

Members of the Residential Treatment Center’s supervisory team must be one of the following: Mental health professionals, Mental health practitioners, Certified Peer Specialists,  Mental health rehabilitation providers, and a Registered nurse who may also  be qualified as a mental health practitioner

RTC providers must have:Sufficient staff for full time delivery of mental health services, as described in a teen’s individual treatment plan, sufficient staff available to safely control and assist with activities of teen clients.

The capacity to respond to emergent needs and make staffing adjustments to assure the health and safety of recipients. This includes providing medical services directly (through its own medical staff) or indirectly (through referral to medical professionals)

Treatment staff must have prompt access, in person or by telephone, to a mental health professional or a qualified mental health practitioner. An IRTS provider must ensure that the program meets the following minimum requirements:

Staff are available to provide guidance and monitoring whenever recipients are present in the facility

Staff remain awake during all work hours

A staffing ratio of at least one staff to nine recipients each day and evening shift

At least one staff member is a mental health professional or practitioner If more than nine recipients are present

Funding Sources for Eligible Teens and Families include:

  • Individual Care Grant
  • Local school districts
  • Private health insurance

Residential Treatment Center Admission Criteria

A teen can be admitted at a Residential Treatment Center when he or she meets the following:

  • • Has a primary diagnosis of mental illness as determined by a Diagnostic Assessment
  • • Has a completed functional assessment using the domains specified in statute and have three or more areas of significant impairment in functioning
  • • Has a completed LOCUS assessment where a Level 5 is indicated
  • • Is reasonably expected to commence or resume illness management and recovery skills or strategies at this level of service
  • • Needs a 24-hour supervised, monitored and focused treatment approach to improve functioning and avoid relapse that would require a higher level of treatment
  • • Is not responsive to an adequate trial of active treatment at a less intensive level of care
  • • Is at risk of significant functional deterioration if IRTS are not received
  • • Has one or more of the following:
  • • History of two or more inpatient hospitalizations in the past year
  • • Significant independent living instability
  • • Homelessness
  • • Frequent use of mental health and related services yielding poor outcomes in outpatient/community support treatment

The professional may consult with the recipient’s:

  • • Mental health case manager
  • • County advocate
  • • Spouse, family member, or significant other (with recipient’s consent)

IRTS Continuing Stay Criteria

Continue the recipient’s stay in IRTS when a mental health professional determines the recipient meets all of the following criteria:

  • • The recipient’s mental health needs cannot be met by other less intensive community-based services
  • • The recipient continues to meet admission criteria as evidenced by active psychiatric symptoms and continued functional impairment
  • • Documentation indicates that symptoms are reduced, but discharge criteria have not been met
  • • The essential goals are expected to be accomplished within the requested time frame
  • • Attempts to coordinate care and transition the recipient to other services have been documented

IRTS Discharge Criteria

Discharge a recipient from IRTS when the recipient meets at least one of the following:

  • • No longer meets continuing stay criteria
  • • Has met ITP goals and objectives
  • • Shows evidence of decreased impairment and appropriate, less restrictive community-based alternatives exist
  • • Has symptoms and needs that permit a lesser level of service and adequate supports and services are in place
  • • Is voluntarily involved in his or her ITP and no longer agrees to participate in the IRTS services
  • • Exhibits severe exacerbation of symptoms, decreased functioning, disruptive or dangerous behaviors and requires a more intensive level of service
  • • Has medical or physical health needs that exceed what can be brought into the residential treatment setting
  • • Does not participate in the program despite multiple attempts to engage him/her and to address nonparticipation issues
  • • Does not make progress toward treatment goals and there is no reasonable expectation that progress will be made
  • • Leaves against medical advice for an extended period (determined by written procedures of provider agency)

Covered Services

Plan and coordinate IRTS with the local mental health service delivery system. Recipients may access and receive services from the program outside of the facility when it would benefit the continuity of treatment and transition to the community. The following services must be available and offered as part of the program design:

Supervision and direction

Individualized assessment and treatment planning

Crisis assistance, development of health care directives and crisis prevention plans

Nursing service

Interagency case coordination

Transition and discharge planning

Living skills development, including: medication, self-administration,healthy living,household management,cooking and nutrition, budgeting and shopping using transportationemployment-related skills

Notethe Rule 36 Variance ensures health and safety of persons receiving services; and developing policy and procedures for the Residential Treatment Center’s programs.

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