Rule 24-2-26.1 - Day Treatment Services - GeneralA. Day Treatment Services are reserved for those children for whom interventions that are less intense and more inclusive have not been successful. Day Treatment Services should be targeted, individualized, and short term, and focus on both academic and behavioral outcomes. Day Treatment Services are mid-level intensity programs designed to promote successful community living and well-being for children and youth with serious emotional disturbance. The services provide an alternative to the more restrictive community-based services, such as acute partial hospitalization and Mississippi Youth Programs Around the Clock (MYPAC), and serve to prevent the need for residential treatment, unnecessary acute psychiatric hospitalizations, and/or minimize disruptions to the child/youth's participation in the regular school setting. Day Treatment Services are based on therapeutic interventions that address the child/youth's underlying condition, as well as the alleviation of current symptomology. Programmatic activities are based on behavior management principles and include, at a minimum, positive feedback, self-esteem building, and social skills training. Additional components are determined by the needs of the participants at a particular service location and may include skills training in topics such as impulse control, anger management, problem solving, and/or conflict resolution.B. At a minimum, one (1) Children/Youth Day Treatment Program must be offered to each school district in the region served by each DMH/C agency provider. Documentation the school district has been offered and explained the Children/Youth Day Treatment Program must be kept on file.C. Children/youth must have the following in order to receive Day Treatment Services:1. An eligibility determination for one (1) of the following: Serious Emotional Disturbance or Autism/Asperger's.2. A justification of the need for Day Treatment Services which must include documentation of the intensity and duration of problems, as part of the initial assessment or as part of a post-intake case staffing and at least annually thereafter.D. Children/youth must be between the ages of three (3)-21 to be considered for enrollment in Day Treatment Services. Group composition must be both age and developmentally appropriate.E. Each individual Day Treatment program must operate at a minimum of two (2) hours per day, two (2) days per week up to a maximum of five (5) hours per day, five (5) days per week. Each child/youth enrolled in Day Treatment Services must receive the service a minimum of four (4) hours per week.F. To ensure each child/youth's confidentiality, no children/youth other than those enrolled in Day Treatment Services can be present in the room during the time Day Treatment Services are being provided.G. Only one (1) Day Treatment Service program is allowed per room during the same time period.H. Each individual Day Treatment Service program must operate under a separate DMH Certificate of Operation.I. The Day Treatment Services Director or their designee (as approved by DMH) must: 1. Supervise, plan, coordinate, and evaluate Day Treatment Services. Supervision must be provided at least one (1) continuous hour per month. This should include participation in clinical staffing and/or Treatment Plan review for the people in the program(s) that they implement or direct.2. Provide at least 30 continuous minutes of direct observation to each individual Day Treatment Service program at least quarterly. Documentation of the supervision/observation must be maintained for review.3. The requirements for Day Treatment Services Director are included in Chapter 11.J. The Day Treatment Specialist must participate in clinical staffing and/or Treatment Plan review for the people in the program that they serve as the primary clinical employee. The requirements for Day Treatment Specialist are included in Chapter 11.K. The DMH Division of Certification must be notified immediately of any interruption of service with an individual Day Treatment program extending over 30 days. If operation has been interrupted for 60 consecutive calendar days, the DMH Certificate of Operation for that individual program becomes inactive beginning on Day 61.L. Day Treatment Services are intended to operate year-round and cannot be designed to operate solely during the summer months.M. Day Treatment Service programs that are unable to provide services during a school's summer vacation will be allowed to hold that individual program Certificate of Operation until it can be reopened the following school year. If the program has not reopened within 60 consecutive calendar days from the first day of the school year, the DMH Certificate of Operation becomes inactive beginning on Day 61.N. Individual Day Treatment Service programs that do not meet during summer vacation must offer services (i.e., Community Support Services, outpatient therapy, etc.) for the child/youth to the parent(s)/legal representative(s) for the period Day Treatment Services are temporarily not in operation. Children and youth who participate in Day Treatment Service programs during the school year that do not operate during summer vacation or breaks of one (1) week or longer must be offered intensive mental health services at least once per week. Documentation must be maintained in each child/youth's record of the services provided. Documentation must also be maintained in the child/youth's record that the availability of intensive services was explained and offered to the parent(s)/legal representative(s). O. Individual Day Treatment programs operated in a school must ensure that Day Treatment Services continue to adhere to all DMH Operational Standards for this service. Day Treatment Services are a separate program from educational programs which must meet applicable Mississippi Department of Education standards and regulations. Day Treatment Services and educational services may not be provided concurrently.P. Each Day Treatment program must be designed and conducted as a therapeutic milieu with the use of a SAMHSA approved evidenced-based curriculum and must include, but not be limited to, such skill areas as functional living skills, socialization or social skills, problem-solving, conflict resolution, self-esteem improvement, anger control, and impulse control. The approved curriculum must be kept on-site. All activities and strategies implemented must be therapeutic, age appropriate, developmentally appropriate, and directly related to the objectives in each child/youth's Individual Service Plan.Q. All Day Treatment Programs must include the involvement of the family or people acting in loco parentis as often as possible, but not less than twice per month, in order to achieve improvement that can be generalized across environments.R. Each Day Treatment Program must operate with a minimum of four (4) and a maximum of 10 children/youth. A Day Treatment roll/roster cannot exceed 10 children/youth per program unless prior approval is given by DMH.S. Day Treatment Programs developed and designed to serve primarily children/youth with a diagnosis of Autism shall not include more than four (4) children/youth with a diagnosis of Autism.T. To participate in the Day Treatment Program, a child/youth must be on the permanent roster for the program. They shall not participate on an intermittent basis.U. Each Day Treatment Program must have a monthly Master Schedule on file at each location to include, at a minimum, the specific skill areas being addressed each day and the specific times these skill areas are being addressed. Skill area activities shown on the Master Schedule must be curriculum specific.V. Each Day Treatment Program must comply with the following:1. A minimum of 20 square feet of usable space per child/youth.2. In programs located in a school, the mental health provider is responsible for ensuring that the school district provides a location that meets all applicable DMH Health, Environment, and Safety requirements. Programs that are conducted in a space that is currently accredited by the Mississippi Department of Education will be considered as meeting all Health, Environment/Safety standards.3. Furnishings, equipment, square footage, and other aspects of the Day Treatment Program environment must be age-appropriate, developmentally appropriate, and therapeutic in nature.W. The ratio of employees to children/youth receiving services in each Day Treatment Program will be maintained at a minimum ratio of two (2) employees on-site for a minimum of four (4) up to a maximum of 10 children/youth per program. Each program must be led by a Day Treatment Specialist. Day Treatment Assistants serve as the second needed employee in this ratio.X. For all children/youth participating in Day Treatment Programs, there must be documentation of plans for transitioning a child/youth to a less intensive therapeutic service. This documentation must be a part of each child/youth's Individual Service Plan and/or case staffing. Transition planning should be initiated when the child/youth begins to receive Day Treatment Services and must be documented within one (1) month of the child/youth's start date for the service.