Chapter 5122-41 | Standards for Psychiatric Residential Treatment Facilities

Rule 5122-41-01 | Purpose, definitions and general standards.

• Effective: October 1, 2023
• Promulgated Under: 119.03

(A) The purpose of this chapter is to describe the standards for a psychiatric residential treatment facility (PRTF).

(B) Definitions:

(1) "Ancillary services" means services that supplement and support the clinical services provided by the PRTF staff and are not considered direct care. An example of an ancillary service in the context of the PRTF setting would be time set aside for personal meditation or reflection.

(2) "Caregiver" means the person identified in the individual plan of care that will ultimately support the timely and effective transition of the youth into the community.

(3) "CMS" means the centers for medicare and medicaid services.

(4) "Department" means the Ohio department of mental health and addiction services.

(5) "Discharge" means a youth is leaving the PRTF without meeting treatment goals.

(6) "Home-like environment" or "home-like" means a living environment that provides for positive, nurturing interactions between caregivers and youth which may reduce the tensions of living in a group setting. Home-like environments provide softness and challenge, stability and flexibility, space for shared living and for private moments. Furnishings should be chosen for comfort as well as for durability. The home-like environment should include items such as artwork, artifacts, plants, pillows, and area rugs to add softness. The selection of wall colors, lighting fixtures, furniture, window treatments, floor coverings, and decorative accessories should also enhance the home-like environment. The home-like environment should not compromise the health and safety considerations of the youth residing in the PRTF.

(7) "Provider agreement" means a contract between the Ohio department of medicaid and an operator of a PRTF for the provision of PRTF services under the medicaid program, pursuant to rule 5160-1-17.2 of the Administrative Code. The signature of the operator or the operator's authorized agent binds the operator to the terms of the Agreement.

(8) "PRTF" means a psychiatric residential treatment facility as defined by 42 C.F.R. 483.354, as authorized under section 1905 (a)(16) and (h) of the Social Security Act.

(9) "Sensory room" means a designated therapeutic space that provides a safe and controlled environment designed to stimulate the senses and promote self-regulation. The room is equipped with various sensory equipment and materials, such as soft lighting, comfortable seating, tactile objects, and calming music, to help individuals manage sensory processing difficulties, reduce stress, and promote relaxation. A sensory room cannot be used for seclusion or restraint.

(10) "Serious injury" means any significant impairment of the physical condition of the youth as determined by qualified medical personnel. This includes, but is not limited to burns, lacerations, bone fractures, substantial hematoma, and injuries to internal organs, whether self-inflicted or inflicted by someone else.

(11) "Transition" means a youth has met their treatment goals and is transitioning to a community setting or a lower level of residential care including a group home.

(12) "Youth" means a person under the age of twenty-one.

(C) A PRTF will:

(1) Be licensed as a class one residential facility pursuant to Chapter 5122-30 of the Administrative Code, but is not required to meet the qualified residential treatment program (QRTP) standards pursuant to rule 5122-30-32 of the Administrative Code. The PRTF license will be congruent with the class one residential facility.

(2) Be selected by the Ohio department of medicaid or its designee to provide PRTF services to Ohio medicaid recipients and obtain and maintain an active provider agreement with the Ohio department of medicaid.

(3) Document PRTF services in accordance with Chapter 5122-27 of the Administrative Code.

(4) Maintain compliance with applicable state and federal laws and regulations.

(5) Hold and maintain other licenses or certificates as applicable, e.g. school, dietary, etc.

(6) Meet the federal emergency preparedness standards of 42 C.F.R. 441.184.

(7) Ensure youths receive equitable access to education.

(8) File an application with the department documenting compliance with the standards of this paragraph.

(D) PRTF psychiatric services for individuals under the age of twenty-one are to be:

(1) Provided under the direction of a physician;

(2) Provided by a psychiatric facility that is not a hospital and is accredited by the joint commission, the commission on accreditation of rehabilitation facilities, or the council on accreditation as a behavioral health residential treatment facility.

(3) Provided before the individual reaches the age of twenty-one, or, if the individual was receiving the services immediately before they reached the age of twenty-one, before the earlier of:

(a) The date the individual no longer needs the services; or,

(b) The date the individual reaches the age of twenty-two.

(4) Documented as necessary with a certification of need, as described in 42 C.F.R. 441.152.

(E) A PRTF will comply with the rules for restraint and seclusion, in accordance with rules 5122-26-16 and 5122-26-16.1 of the Administrative Code.

(F) Serious occurrence incident notification.

(1) A PRTF will meet the incident reporting standards of rule 5122-30-16 of the Administrative Code for residential facilities.

(2) In addition to the incident notification standards of rule 5122-30-16 of the Administrative Code, a PRTF will also report the following serious occurrences in writing to the department, the Ohio department of medicaid if the individual is medicaid eligible, and disability rights Ohio by the close of business the next business day following the incident:

(a) Youth death, which will also be reported to the CMS regional office.

(b) Suicide attempt.

(c) Serious injury.

(d) Substantiated abuse or neglect.

(3) The report will include the name of the youth; a description of the occurrence; and the name, street address, and telephone number of the facility.

(4) In the case of a minor, the facility will notify the youth's parents, custodian, or legal guardian as soon as possible, and in no case later than twenty-four hours after the incident.

(5) Staff will document in the youth's record that the serious occurrence was reported in accordance with this paragraph, including the name of the person with the Ohio department of medicaid and disability rights Ohio and the name of the parents, custodian, or legal guardian to whom the incident was reported. A copy of the report will be maintained in the youth's record, as well as in the incident and accident report logs kept by the facility.

(G) Each PRTF will collect and analyze PRTF performance improvement and outcomes data to identify areas of focus and performance improvement.

Last updated October 2, 2023 at 8:35 AM

Supplemental Information

Authorized By: 5119.141
Amplifies: 5119.141, 5119.34
Five Year Review Date: 10/1/2028

Rule 5122-41-02 | Psychiatric residential treatment facility model.

• Effective: October 1, 2023
• Promulgated Under: 119.03

(A) Psychiatric residential treatment facility (PRTF) is a trauma informed, inpatient level, intensive multi-disciplinary residential treatment provided in a non-acute setting for youth with complex needs. A PRTF delivers trauma-informed, evidence-based individualized services to youth in order to stabilize behaviors in as short as possible time frame, and help youth and their family or caregiver to develop the knowledge and skills needed to safely manage their needs in the community, so that the youth can succeed in all aspects of community living, e.g. home and family, school, employment, etc.

(B) Individuals referred to PRTF programs are youth with complex needs including significant behavioral challenges. These individuals have a mental health diagnosis or co-occurring mental health and other diagnosis, e.g. substance use, intellectual disability, and at least one of the following:

(1) Exhibiting severe mental health symptoms at the time of the referral to PRTF.

(2) Documented severe functional impairment in comparison to same age peers or same developmental age peers in multiple life domains (school performance, family relationships, interpersonal relations, communication/thought processes, self-care, and community) as reflected in the most recent Ohio children's initiative child and adolescent needs and strengths (CANS) assessment and other clinical documentation. If an Ohio children's initiative CANS assessment has not been completed or did not result in a recommendation of PRTF, clinical documentation indicating severe functional impairment may be used.

(C) PRTF model description.

(1) Provided seven days a week to youth.

(2) Physician directed.

(3) Multi-disciplinary.

(4) Treatment is focused on the objectives that are most important for the youth to address to achieve a successful transition to their community.

(5) Able to address the intensive treatment, supervision, and safety needs of the youth.

(6) Possess the capacity and expertise to provide targeted treatment services to address the variety of needs of the youth.

(7) Treatment is strength-based, individualized, and the quantity and frequency of services is adjusted based upon the needs of individuals and the culture of the milieu.

(8) Have sensory regulation items and equipment available for youths as needed.

(9) Inclusive of evidence-based treatment services that focus on the strengths of the youth and their family or caregiver.

(10) Have qualified staff who are Ohio children's initiative CANS certified assessors, who will conduct the follow-up CANS when other appropriate entities (care management entities, community behavioral health centers, etc.) have not conducted the CANS.

(11) Consists of appropriate therapeutic, educational, recreational, and medical services, including referral and transportation to services that are not provided by the PRTF.

(12) Available to the youth and family or caregiver post transition.

(13) Utilizes performance improvement processes to monitor performance, address problem areas and troubleshoot, and assure provision of quality services.

(14) Facilitate continued OhioRISE care coordination (including in person visits and facilitating CANS assessments by the OhioRISE care coordinator) throughout treatment and the PRTF will participate in the OhioRISE child and family team.

(D) A PRTF is inpatient level of care provided in a non-acute home-like environment.

(1) The PRTF will be in either:

(a) A separate, free-standing building; or,

(b) In a building with other services, which may include a class one residential facility, however the PRTF will be located on a separate floor or in a separate unit or wing. There may be only incidental interaction between youths in the PRTF and the class one residential facility residents who are not in the PRTF when clinically appropriate.

(2) The PRTF will provide to each youth a bedroom of not more than a double occupancy while meeting all other standards regarding sleeping space in rule 5122-30-14 of the Administrative Code. In PRTFs serving youth with co-occurring behavioral health and intellectual or developmental disabilities each bedroom will be single occupancy.

(3) The PRTF will respect as much as possible the youth's choice regarding services and supports, and who provides them.

(4) The PRTF will allow the youth to have input into the choice of schedule and activities, and food options as clinically appropriate.

(5) The PRTF will allow the youth freedom to furnish and decorate their sleeping and living areas as much as possible while being consistent with considerations for the health and safety of the youth.

(6) The PRTF will meet the following for the living and dining space of the facility in addition to the standards in rule 5122-30-14 of the Administrative Code:

(a) Have a meeting space that is large enough to accommodate all youths at the same time;

(b) Have a communal area that provides space and opportunities for small group activities and socializing; and,

(c) Have entertainment or recreational areas, including furnishings, that promote social engagement.

(7) Notwithstanding paragraph (T) of rule 5122-30-12 of the Administrative Code, a PRTF may restrict youth's ability to leave the facility by means of locked doors. If a PRTF locks doors on the facility or unit within the facility, then all lockable doors will have delayed egress locks in accordance with the Ohio building code. Staff will also be immediately available on the premises to open the door for any youth. Doors will be operable from the outside by local fire departments via a fire department access box or key.

(E) The PRTF treatment environment:

(1) Utilizes a trauma-informed treatment model that is approved by the department for the population the PRTF serves. A trauma-informed treatment model is a program, organization or system that:

(a) Realizes the widespread impact of trauma and understands potential paths for recovery;

(b) Recognizes the signs and symptoms of trauma in clients, families, staff and others involved with the system;

(c) Responds by fully integrating information about trauma into policies, procedures and practices;

(d) Seeks to actively resist re-traumatization; and,

(e) Includes service of clinical needs and:

(i) Is an approved trauma informed treatment model applicable to the population of youth served located at http://jfs.ohio.gov/ocf/Family-First.stm; or,

(ii) Meets the ten substance abuse and mental health services administration (SAMHSA) implementation domains and follows the six key principles of the SAMHSA trauma informed approach which are located at http://jfs.ohio.gov/ocf/Family-First.stm.

(2) Reduces and avoids re-traumatization that can occur in a residential treatment environment.

(3) Is nurturing, non-coercive, family-friendly, and provides for normalcy and consistency. The PRTF does not use punitive systems, e.g. a level system where a youth may lose an earned level.

(4) Focuses on assisting youth with self-regulation.

(5) Utilizes trauma-informed strategies around safety as part of engagement, including developing soothing plans for each youth, as well as incorporating other strategies and tools such as making available the use of sensory items for a youth.

(6) Utilizes staff that can recognize crisis triggers during treatment, assist the youth if needed with implementing individual soothing plans, and engage with the youth to prevent the escalation of behaviors.

(7) Is culturally, linguistically, and developmentally appropriate for the youths served.

(8) Includes a sensory room will be available to the youth.

Last updated October 2, 2023 at 8:35 AM

Supplemental Information

Authorized By: 5119.141
Amplifies: 5119.141, 5119.34
Five Year Review Date: 10/1/2028

Rule 5122-41-03 | PRTF admission criteria, admissions, and discharges.

• Effective: October 1, 2023
• Promulgated Under: 119.03

(A) The PRTF will develop its admission criteria and assure that it has the staff and resources available to meet the needs of referred youths who fit its admission criteria. Admission criteria includes attention to:

(1) Age.

(2) Gender.

(3) Behaviors the PRTF will treat, which includes treating aggressive individuals.

(4) Exclusionary behaviors or diagnoses that the PRTF will not have the capacity to treat, if any, e.g. sexualized behaviors or eating disorders.

(B) PRTF will admit a youth when the need for PRTF has been determined and the youth meets the PRTF's written admission criteria in conjunction with the youth's OhioRISE care coordination and child and family team.

(C) The PRTF will maintain a staff hiring and on-going staff development system (which may include training by entities external to the PRTF) to assure staff have sufficient competencies to address the needs of the youth described in the PRTF's admission criteria.

(D) The PRTF will not initiate a transition of a youth prior to completion of successful treatment, as defined in individual plan of care, unless the age criteria set in paragraph (D)(3) of rule 5122-41-01 of the Administrative Code has been exceeded, including if the youth temporarily leaves the PRTF for admission to a hospital for medical or psychiatric care for up to three days per event, unless the youth is transferred to another PRTF that can better meet the youth's treatment needs. This does not permit a PRTF to refuse to discharge a youth when the legal custodian has requested discharge.

(E) There will be documented evidence of active, individualized transition planning in conjunction with the youth's OhioRISE care coordination and child and family team.

Last updated October 2, 2023 at 8:35 AM

Supplemental Information

Authorized By: 5119.141
Amplifies: 5119.141, 5119.34
Five Year Review Date: 10/1/2028

Rule 5122-41-04 | Youth and family engagement.

• Effective: October 1, 2023
• Promulgated Under: 119.03

(A) PRTF is a youth and family driven service. The youth and family/caregivers are viewed as full participants in the treatment team and their needs, preferences, and choices are valued and respected.

(B) Family is defined by the youth and caregiver in a manner consistent with the OhioRISE care coordination process, and through conversations with the PRTF team and the youth and caregiver.

(C) The PRTF will provide the family or caregiver clear communication and explanations related to the youth's service needs at a frequency defined by the youth, their family, and care plan.

(D) The youth will be asked directly for their input on and offered choices in their treatment services, Their input and choices are respected and incorporated into the plan of care whenever clinically and developmentally appropriate.

(E) The PRTF actively engages the family or caregiver. When applicable, this occurs in partnership with the care management entity or care coordination entity.

(1) The family or caregiver is invited to participate in treatment team meetings, which are held at times convenient to the family or caregiver.

(2) Families are encouraged to be full participants in their children's ongoing care including participation in clinical appointments. The family or caregiver is invited to participate in family counseling from the time of the youth's placement in the PRTF unless clinically contraindicated and documented.

(3) The PRTF will provide additional family services and supports or refer the family or caregiver in collaboration with the child and family team for recommended individualized services and supports in the community, e.g. individual therapy, parenting classes, parent mentors or peer supports, or parenting self-care information, etc.

(F) The PRTF will coordinate with the Title IV-E agency for services for youth in Title IV-E agency's custody.

(G) PRTF visitation policies promote face-to-face contact.

(H) PRTF makes available and utilizes technology for visitation, clinical services, education, and treatment team meetings.

(I) The PRTF includes the family or caregiver in transition planning.

Last updated October 2, 2023 at 8:35 AM

Supplemental Information

Authorized By: 5119.141
Amplifies: 5119.141, 5119.34
Five Year Review Date: 10/1/2028

Rule 5122-41-05 | Care coordination, transition planning, and continuity of care.

• Effective: October 1, 2023
• Promulgated Under: 119.03

(A) The PRTF coordinates care with other providers during treatment, as part of transition planning and after treatment.

(B) The PRTF recognizes that transition to the community is challenging for the youth and family or caregiver and assures that services and supports are in place to support the youth's successful return to the community.

(C) Individualized transition planning begins within twenty-four hours of admission with a strong focus on family and caregiver education and engagement in the care of youth, and coordination with partnering entities.

(D) The PRTF partners with OhioRISE care coordination to develop discharge plan back into the community that includes consistent collaboration during the youth's PRTF stay.

(E) The PRTF partners with the youth and family to engage and utilize natural community supports as part of transition planning.

(F) The PRTF coordinates with community providers or partners prior to the transition to ensure services are not interrupted.

(G) PRTFs serving youth with co-occurring behavioral health and intellectual or developmental disabilities will coordinate with the department of developmental disabilities assigned regional coach.

(H) The PRTF will make training available to family and community partners, as needed to serve the needs of the youth.

(I) The PRTF is available to community partners, as well as the youth and family or caregiver at least six months post discharge when the youth is transitioned to a community setting, including at least monthly contact with the youth and family or caregiver unless the youth and family or caregiver decline this contact when the PRTF discusses it and offers it as part of discharge planning.

(J) The PRTF provides written documentation to all participants of the transition plan at least forty-eight hours prior to the youth leaving the PRTF with information on how to access additional supports from the PRTF and community providers including contact information and steps necessary to access each provider.

Last updated October 2, 2023 at 8:36 AM

Supplemental Information

Authorized By: 5119.141
Amplifies: 5119.141, 5119.34
Five Year Review Date: 10/1/2028

Rule 5122-41-06 | Staffing, staffing qualifications, and staff ratios.

• Effective: October 1, 2023
• Promulgated Under: 119.03

PRTF staff will be:

(A) Physician medical director. If the medical director is not a board certified or board eligible psychiatrist, the PRTF will also employ or contract with a psychiatrist who meets this qualification.

(B) Administrative director, who will meet one of the following qualifications:

(1) Master's degree in human services field plus two years prior human services supervisory experience; or,

(2) Bachelor's degree in human services field plus four years prior human services program supervisory experience.

(C) Clinical director with two years clinical experience in a mental health setting that served children or adolescents with emotional problems.

(1) The clinical director may also serve as the administrative director.

(2) The physician medical director may also serve as the clinical director if employed at least forty hours per week.

(D) Sufficient clinical staff to meet each youth's treatment needs and who are appropriately credentialed to provide mental health services. If the PRTF provides services to youth with co-occurring substance use disorders, sufficient clinical staff will be credentialed to provide substance use disorder treatment. If the PRTF provides services to youth with intellectual or developmental disabilities, the PRTF will have sufficient clinical staff with expertise in treatment for youth with disabilities.

(E) Sufficient direct care staff to meet all youths' supervisory and care needs.

(1) During the hours of eight a.m. until ten p.m., the PRTF will maintain a staffing ratio of at least one direct care staff for each three youths, except that the ratio will be one direct care staff for each two youths with intellectual or developmental disabilities. The PRTF will have a minimum of two direct care staff at all times, including a practitioner with a scope of practice of at least a registered nurse, physician assistant, or advance practice nurse.

(2) During the hours of ten p.m. until eight a.m., the PRTF will maintain a staffing ratio of at least one direct care staff for each six youths. The PRTF will have a minimum of two direct care staff at all times, including a practitioner with a scope of practice of at least a licensed practical nurse.

(F) The PRTF includes additional staff as needed to meet youth's dietary, educational, social recreational, and other needs.

(G) If there is another residential facility or outpatient services on the grounds where the PRTF is located, when direct care and nursing staff are on-duty in the PRTF, these staff are specifically assigned to the PRTF with duties separate from other services, e.g. acute, other residential, or outpatient services.

(H) The PRTF increases staff when necessary to meet the acuity needs of the youth.

(I) The following staff will be on call at all times and available to come on-site to the PRTF when one is not available on-site:

(1) A psychiatrist, doctorate level behavioral health professional, clinical nurse specialist, certified nurse practitioner, physician's assistant, or physician with behavioral health experience; and,

(2) Licensed clinician. With the exception of a certified nurse practitioner, this does not include staff who are registered or certified by an Ohio licensing board, e.g. a registered social work assistant or certified chemical dependency counselor assistant.

Last updated October 2, 2023 at 8:36 AM

Supplemental Information

Authorized By: 5119.141
Amplifies: 5119.141, 5119.34
Five Year Review Date: 10/1/2028

Rule 5122-41-07 | Individual plan of care and services.

• Effective: October 1, 2023
• Promulgated Under: 119.03

(A) PRTF services will involve "active treatment," which means implementation of a professionally developed and supervised individual plan of care described in paragraph (B) of this rule, that is:

(1) Developed and implemented as soon as possible but not later than fourteen days after admission; and,

(2) Designed to achieve the youth's transition from the PRTF at the earliest possible time.

(B) Individual plan of care.

(1) The individual plan of care will be in writing and developed for each youth in order to improve their condition to the extent that PRTF care is no longer necessary.

(2) The plan of care will:

(a) Be based on a diagnostic evaluation that includes examination of the medical, psychological, social, behavioral, and developmental aspects of the youth's situation and reflects the need for PRTF care.

(b) Be developed by a team of professionals specified in paragraph (D) of this rule in consultation with the youth and their parents or caregiver and legal guardians if applicable.

(c) State treatment objectives.

(d) Prescribe an integrated program of therapies, activities, and experiences designed to meet the objectives.

(3) When a PRTF includes youth with intellectual or developmental disabilities in its admission criteria, the examination will also include an assessment by an occupational therapist to address underlying sensory needs and communication needs.

(C) The plan will be reviewed at least every thirty days, and more often when clinically indicated, by the team specified in this rule and the youth and family to:

(1) Determine that services being provided are or were necessary to be provided in a PRTF; and,

(2) Recommend changes in the plan as indicated by the youth's overall progress in the PRTF.

(D) Team developing and reviewing individual plan of care.

(1) The individual plan of care developed in accordance with this rule will be developed and reviewed by the interdisciplinary team identified in this paragraph. The members of the team will be employed by or provide services to the youth in the PRTF and their family or caregiver.

(2) Based on education and experience, including competence in child psychiatry, the team will be able to:

(a) Assess the youth's immediate and long-range therapeutic needs, developmental priorities, and personal strengths and liabilities;

(b) Assess the potential resources of the youth's family;

(c) Set treatment objectives; and,

(d) Prescribe therapeutic modalities to achieve the plan's objectives.

(3) At a minimum, the team will include one of the following:

(a) A board-eligible or board-certified psychiatrist;

(b) A licensed psychologist and a physician licensed to practice medicine or osteopathy; or,

(c) A physician licensed to practice medicine or osteopathy with specialized training and experience in the diagnosis and treatment of mental illness, and a clinical psychologist who has a master's degree in clinical psychology.

(4) The team will also include one of the following:

(a) An individual with competency in behavioral health who is one of the following: a licensed social worker, an independent social worker, a licensed professional counselor, a professional clinical counselor, a licensed marriage and family therapist, or an independent marriage and family therapist;

(b) A registered nurse, certified nurse practitioner or clinical nurse specialist with specialized training or one year of experience in treating individuals with behavioral health needs, e.g. mental illness or substance use disorder; or,

(c) A licensed psychologist.

(5) When a PRTF includes youth with intellectual or developmental disabilities in its admission criteria, the team will include an occupational therapist with experience in working with youth with intellectual or developmental disabilities.

(E) A PRTF will provide to a youth all of the following treatment and other services:

(1) A physical health examination by a physician or advanced practice registered nurse not later than twenty-four hours after admission; the PRTF will not compel but may accept an examination completed within seventy-two hours prior to admission to meet this standard.

(2) A psychiatric evaluation by a psychiatrist or other qualified independent medical practitioner not later than forty-eight hours after admission; the PRTF will not compel but may accept an examination completed within seventy-two hours prior to admission to meet this standard.

(3) Psychiatric services when clinically indicated. Psychiatric services will be available at all times on site or by telephone.

(4) Nursing services when clinically indicated.

(5) Education services that meet the minimum standards applicable to city, local, or exempted village school districts, community schools, and chartered nonpublic schools as set forth in agency 3301 of the Administrative Code.

(6) Organized recreational activities.

(7) Transportation to other medical services, including laboratory, dental, vision, physical therapy, occupational therapy, or speech therapy, which the PRTF may provide directly or through a contractor.

(F) In addition to the treatment and other services specified in paragraph (E) of this rule, a PRTF will provide to each youth the following therapeutic services:

(1) A face-to-face consultation, lasting at least fifteen minutes, and occurring not less than once a week with a psychiatrist; other qualified physician; or a prescriber either under the direction of a physician or other practitioner with prescribing authority or practicing under a collaborative agreement;

(2) Individual counseling sessions with a licensed clinician, occurring not less than twice a week, for a total of at least ninety minutes each week;

(3) Group counseling sessions with a licensed clinician, occurring not less than five times a week, for a total of at least five hours each week;

(4) Family therapy or other family interventions in accordance with the youth's individualized plan of care;

(5) Art and music therapeutic services will be available to all youth in accordance with the youth's individualized plan of care;

(6) Medication administration, monitoring, and education as prescribed;

(7) Substance use disorder treatment in accordance with the American society of addiction medicine (ASAM) criteria when clinically indicated and included in the PRTF's admission criteria; and,

(8) Ancillary services based on the youth's clinical needs as indicated in the youth's individualized plan of care, provided seven days a week for at least two hours each day.

At least one therapeutic service specified in this paragraph will be provided on site each day. The provision of all therapeutic services specified in this paragraph will not amount to less then eight hours, total, each week.

Last updated October 2, 2023 at 8:36 AM

Supplemental Information

Authorized By: 5119.141
Amplifies: 5119.141, 5119.34
Five Year Review Date: 10/1/2028

Rule 5122-41-08 | Staff training.

• Effective: October 1, 2023
• Promulgated Under: 119.03

(A) All clinical staff will receive initial training in evidence-based practices utilized by the PRTF within thirty days of hire and on-going training thereafter as needed.

(B) All staff and volunteers will:

(1) Receive training in de-escalation strategies which includes practicing techniques presented prior to working with youth in the PRTF and at least every twelve months thereafter.

(2) Trauma-informed training is to occur within the first thirty days after the date of hire, and annually thereafter. The necessary trauma competencies are located at http://jfs.ohio.gov/ofc/Family-First.stm.

(3) Complete training in the following, as appropriate to their role, within thirty days of hire:

(a) Cultural competency; and,

(b) Health care provider communications.

(4) Complete training in calming and coping strategies within thirty days of hire.

(5) Complete training in anti-bullying techniques within thirty days of hire.

(C) All non-clinical staff will complete "Mental health first aid for youth" training within ninety days of hire. When a PRTF includes youth with intellectual disabilities in its admission criteria, training should incorporate "mental health first aid intellectual disability guidelines."

(D) Staff that supervise day-to-day provision of services and staff who directly provide services in PRTF that accepts youths with intellectual/developmental disabilities will complete the Ohio department of developmental disabilities "supporting youth with intensive and complex needs" training within thirty days after hire.

(E) After initial training, direct care staff excluding credentialed clinical and nursing staff receive at least twenty hours of relevant on-line or in person training every twelve months. Examples of topics include mental illness, substance use disorder, working with residential youth, and family engagement. The training in paragraph (B)(1) of this rule may be included in the twenty hours.

Last updated October 2, 2023 at 8:36 AM

Supplemental Information

Authorized By: 5119.141
Amplifies: 5119.141, 5119.34
Five Year Review Date: 10/1/2028