Treatment Planning

Treatment Planning A. Treatment planning is defined by the Division of Medicaid as a collaborative venture which the members of various disciplines jointly develop a comprehensive, individualized plan for the treatment of each resident. 1. The treatment plan charts a course designed to help the resident move to a less restrictive level of care as quickly as possible. 2. An initial treatment plan must be in effect within seventy-two (72) hours after the resident’s admission to the facility. 3. The interdisciplinary treatment team must meet to discuss, approve and implement a more comprehensive treatment plan within fourteen (14) days after the resident’s admission, once at the conclusion of the first (1st) month of stay, and once a month thereafter. 4. The treatment plan document must contain evidence of the resident’s and his/her parent/guardian’s active participation in the treatment planning/review/revision process. B. The treatment team should include as many staff as possible who are involved in the treatment of the resident. 1. At a minimum, the team must include, either: a) A board-certified child/adolescent psychiatrist or a psychiatrist who has successfully completed an approved residency in child/adolescent psychiatry, or b) A Psychiatric Mental Health Nurse Practitioner (PMHNP) and a physician licensed to practice medicine or osteopathy, or c) A licensed psychologist and a physician licensed to practice medicine or osteopathy. 2. The team must also include one (1) of the following: a) A licensed certified social worker who has a minimum of one (1) years’ experience in treating children with serious emotional disturbances (SED), or b) A registered nurse who has a minimum of one (1) years’ experience in treating individuals with SED. C. The treatment plan delineates all aspects of the resident’s treatment and includes, at a minimum: 1. A multi-axial diagnosis. 2. An assessment of the resident’s immediate therapeutic needs. 3. An assessment of the resident’s long-range therapeutic needs. 4. An assessment of the resident’s personal strengths and liabilities. 5. Identification of the clinical problems that are to be the focus of treatment. 6. Measurable and realistic treatment goals for each identified problem. 7. Observable, measurable treatment objectives that represent incremental progress towards goals, coupled with target dates for their achievement. 8. Specific treatment modalities and/or strategies that will be employed to reach each objective. a) Special procedures must not be included in the treatment plan unless justified by current or historical evidence of aggressive behavior which, cannot be controlled by less restrictive interventions. b) If special procedures become necessary, the treatment plan must be amended or modified within one (1) working day of the first incident to reflect the use of the least restrictive necessary measures. 9. The clinician identified as responsible for each aspect of treatment. 10. Identification of goals, objectives and treatment strategies for the family as well as the resident, and identification of the clinician responsible for family treatment. If a geographically distant therapist will be utilized, this must be specified in the treatment plan. 11. An individualized discharge plan that includes: a) Discharge criteria, indicating specific goals to be met, b) An estimated discharge target date, and c) No later than seven (7) days prior to discharge, the discharge plan must also include an aftercare plan that addresses coordination of family, school/vocational and community resources to provide the greatest possible continuity of care for the resident. D. The treatment team must meet to staff each resident and review/revise his/her treatment plan as often as necessary to provide optimum treatment. The treatment review team must assess the resident’s progress in treatment by: 1. Noting treatment successes, discussing which objectives and/or goals have been achieved and when, and explaining treatment failures. 2. Making changes in the treatment plan, as needed. 3. Re-assessing the child's need for continued residential care, as opposed to less restrictive treatment. 4. Noting the child's measurable progress towards discharge, reviewing/revising the discharge criteria and/or target date as needed.