NDAC 75-03-17-05
Diagnosis and treatment while at the facility
Cite as N.D. Admin. Code ยง 75-03-17-05
1.
Duties of the facility. The facility shall:
a.
Provide for a medical, psychiatric, and psychological assessment of each child no later
than seventy-two hours after admission;
b.
Immediately include family and custodians in the active treatment;
c.
Involve the families and the person who may lawfully act on behalf of the child in the
person-centered treatment plan;
d.
Provide daily therapy and programming that are individually tailored to meeting a child's
need and in sufficient volume to resolve immediate inpatient need. Therapies must
include individual and family components to facilitate rapid return of the child to a family
setting;
e.
Provide ongoing and consistent individual therapy utilizing evidence-based models of
care for psychiatric residential treatment facilities for children. Individual therapy must
focus on providing the child skills they need to be successful in their home and
community;
f.
Complete a diagnostic assessment, completed by a licensed psychiatrist, no less than
seventy-two hours after admission that includes:
(1)
A psychiatric history;
(2)
A mental status examination, including an assessment of suicide;
(3)
Psychosocial, including family history; and
(4)
Complete set of diagnosis and recommendations for immediate treatment; and
g.
Ensure therapeutic leave such as weekend overnight visits or day passes with family
must be documented in the child's case file and be tied to family therapy and therapeutic
goals of the child and family, or it must be documented in the child's case file why
weekend overnight visits or day passes are not tied to therapy and therapeutic goals of
the child and family.
2.
Specialists. The facility shall provide a sufficient number of qualified psychiatric professionals
to meet the resident needs. Each facility shall provide a minimum of one-half hour per week
per bed of psychiatry time, one hour per week per bed of family therapy time, and two hours
per week per bed of individual therapy time. Each facility shall provide twenty-four-hour
nursing, which may include a combination of onsite or on-call hours.
3.
Individual person-centered treatment plan.
a.
The facility shall develop and implement an individual person-centered treatment plan
that includes the child's input giving the child a voice and a choice in the treatment
planning and interventions used. The plan must be based upon a comprehensive
interdisciplinary diagnostic assessment, which includes the role of the family, identifies
the goals and objectives of the therapeutic activities and treatment and it must be
developed by an interdisciplinary team. The plan must provide a schedule for
accomplishing the therapeutic activities and treatment goals and objectives, and identify
the individuals responsible for providing services to children consistent with the individual
person-centered treatment plan. Clinical supervision for the individual person-centered
treatment plan must be accomplished by full-time or part-time employment of or contracts
with a licensed psychiatrist, a licensed psychologist, a licensed clinical social worker, or a
nurse who holds advanced licensure in psychiatric nursing. Clinical supervision must be
documented by the clinical supervisor cosigning individual person-centered treatment
plans and by entries in the child's record regarding supervisory activity. The child, and the
person who lawfully may act on the child's behalf, must be involved in all phases of
developing and implementing the individual person-centered treatment plan. The child
may be excluded from planning if excluding the child is determined to be in the best
interest of the child and the reasons for the exclusion are documented in the child's plan.
b.
The plan must be:
(1)
Based on a diagnosis using the current diagnostic and statistical manual of mental
disorders and a biopsychosocial assessment;
(2)
Developed within three business days of admission; and
(3)
Reviewed at a minimum every fourteen days and updated or amended to meet the
needs of the child by the interdisciplinary team.
c.
The person-centered treatment plan must identify:
(1)
Treatment goals that are short term and intense, focused on successful return to
home and community;
(2)
Time frames for achieving the goals;
(3)
Goals that are achievable and measurable;
(4)
The individuals responsible for coordinating and implementing child and family
treatment goals;
(5)
Therapeutic intervention or techniques or both for achieving the child's treatment
goals;
(6)
The projected length of stay and discharge plan; and
(7)
Referrals made to other service providers based on treatment needs, and the
reasons referrals are made.
4.
Solicitation of funds. A facility may not use a child for advertising, soliciting funds, or in any
other way that may cause harm or embarrassment to a child or the child's family. A facility may
not make public or otherwise disclose by electronic, print, or other media for fundraising,
publicity, or illustrative purposes, any image or identifying information concerning any child or
member of a child's immediate family, without first securing the child's written consent and the
written consent of the person who may lawfully act on behalf of the child. The written consent
must apply to an event that occurs no later than ninety days after the date the consent was
signed and must specifically identify the image or information that may be disclosed by
reference to dates, locations, and other event-specific information. Consent documents that
do not identify a specific event are invalid to confer consent for fundraising, publicity, or
illustrative purposes. The duration of an event identified in a consent document may not
exceed fourteen days.