N.M. Admin. Code § 7.20.11.30

Current through Register Vol. 35, No. 23, December 10, 2024

Section 7.20.11.30 - RESIDENTIAL TREATMENT SERVICES AND GROUP HOME SERVICES

A. Residential treatment services are provided to children/adolescents with severe behavioral, psychological, neurobiological, or emotional problems, who are in need of psychosocial rehabilitation in a residential setting. They require active residential psychotherapeutic intervention and a 24-hour therapeutic group living setting to meet their developmental, psychological, social, and emotional needs.

B. Group home services are provided to children/adolescents with moderate behavioral, psychological, neurobiological, or emotional problems, who are in need of active psychotherapeutic intervention, who require a twenty-four hour therapeutic group living setting to meet their developmental, social and emotional needs, and/or who are in transition from a higher level of care to a lower level of care.

C. The agency maintains and follows policies and procedures for emergency and non-emergency admissions. Admission policies and criteria are based on the client's identified need for residential treatment services or group home services.

D. At the time of admission or transfer to residential treatment services or group home services, the client is informed of the reasons for the placement/transfer and his/her treatment options. This discussion with the client is documented in the client's record by the admitting professional.

E. Personnel:

(1) Direct service staff providing residential treatment services and/or group home services receive a minimum of twenty hours of pre-service training, including training in:

(a) crisis management/intervention, behavioral management, personal restraint and seclusion;

(b) the agency's emergency procedures, which include CPR and first aid.

(2) The direct service staff possess a high school diploma or G.E.D and one or more of the following:

(a) two years experience working with clients and adolescents with severe psychological/ emotional disturbances/neurobiological disorders; or

(b) two years of post-secondary education in a human service related field; or

(c) a minimum of 40 hours of documented training, including the twenty hours of pre-service training described in E above, and twenty additional hours including the following topics:

(i) etiology and symptoms of emotional disturbances and neurobiological disorders;

(ii) family systems;

(iii) basic communication and problem solving;

(iv) child and adolescent development;

(v) ethnic and cultural considerations related to the clients served; and

(vi) action and potential side effects of medications.

(3) The training in (c) (i) through (vi) above, when required, must be provided within three months of hire.

(4) Those direct service staff who, prior to beginning direct service work, can provide documentation of a current certificate of training in one or more of these specified areas are not required to repeat that training; their training requirements may be adjusted as justified and documented by the clinical director or designee.

(5) Clinical director:

(a) Clinical director qualifications: The clinical director possesses one of the following New Mexico licenses: physician (physicians must be board-certified in psychiatry or eligible to attain such certification); psychologist; licensed independent social worker (LISW); clinical nurse specialist in child psychiatric nursing; registered nurse (RN) with a master's in psychiatric nursing; licensed professional clinical mental health counselor (LPCC); and licensed marriage and family therapist (LMFT);

(b) In addition to having one of the above licenses, the clinical director is required to have a minimum of two years of experience in clinical practice with clients, adolescents, and families.

(c) Clinical director responsibilities: The responsibilities of the clinical director are to provide clinical oversight of the services, as well as to provide supervision, support, and consultation to all agency staff.

(6) Clinical supervisor qualifications: The clinical supervisor possesses one of the following New Mexico licenses: physician (physicians must be board-certified in psychiatry or eligible to obtain such certification); psychologist; licensed independent social worker (LISW) or other licensed independent practitioner in a related field; clinical nurse specialist in child psychiatric nursing; registered nurse (RN) with a master's in psychiatric nursing; licensed professional clinical mental health counselor (LPCC); or licensed marriage and family therapist (LMFT). In addition to having one of the above licenses, the clinical supervisor is required to have a minimum of two years of experience in clinical practice with clients, adolescents and families.

(7) Therapists qualifications: Therapists providing individual, family and/or group therapy must meet either the necessary licensed requirements as listed for clinical supervisor or possess one of the following New Mexico licenses: licensed professional mental health counselor (LPC); licensed master's social worker (LMSW); licensed art therapist (LAT); or licensed mental health counselor (LMHC).

F. Services:

(1) Residential treatment services are provided through a treatment team approach and the roles, responsibilities and leadership of the team are clearly defined.

(2) The agency provides a daily structured program that meets clients' needs as identified in the comprehensive assessment and as prescribed in the treatment plan. The following services are provided:

(a) individual, family, and group therapy, at the level of frequency documented in the treatment plan;

(b) access to timely and necessary medical care;

(c) supervision of self-administered medication, if appropriate;

(d) crisis intervention;

(e) educational services;

(f) activities of daily living;

(g) recreation, leisure time and other planned therapeutic activities; and

(h) planning of discharge and aftercare services; to facilitate timely and appropriate post discharge care, regular assessments are conducted to support discharge planning and effect successful discharge with clinically appropriate aftercare services; this discharge planning begins when the client is admitted to residential treatment services and is updated and documented in the client's record at every treatment plan review, or more frequently as needed.

(3) The agency provides services, care, and supervision at all times, including:

(a) the provision of, or access to, medical services on a 24-hour basis;

(b) maintenance of a staff-to-client ratio appropriate to the level of care and needs of the clients.

(i) for residential treatment services, the minimum ratios are one to six during the day and evening shifts and one awake staff to twelve clients during the night shift.

(ii) for group home services, the minimum ratios are one to eight during the day and evening shifts and one awake staff to twelve clients during the night shift.

(iii) additional staff must be provided if the clinical needs of the client population are high.

(iv) a written schedule must be maintained by the agency to document the staffing ratios.

(c) arrangements for, and provision of, supervision for off-grounds activities, including transportation, in accordance with minimum and need-based ratios; and

(d) arrangements for, and provision of responses to significant life events that may affect the client's treatment when out of the facility.

(4) Services and activities are appropriate to the age, behavioral, and emotional development level of the client.

(5) When not therapeutically or legally contraindicated, the agency encourages parent/client contact and makes efforts at family reunification. Such contacts and efforts are documented as they occur. If reunification is contraindicated, the reason is documented in the client's record at the time that determination is made, and the issue is reconsidered when indicated.

(6) The following factors will be considered in determining the appropriate level of services and supervision.

(a) risk of victimizing others;

(b) risk of inappropriate consensual activity;

(c) risk of being victimized by others;

(7) The treatment plans contain all the elements outlined in Section 23 of these certification requirements.

G. Residential treatment services and group home services may be provided in the same licensed facility when the agency ensures the health and safety of all clients present.

(1) A program certified for residential treatment services may provide group home services in accordance with these certification requirements without requesting or receiving a separate certification for group home services.

(2) When residential treatment services and group home services are provided in the same facility, the agency's policies and procedures specify clinically-based criteria under which the populations may be mixed.

(3) When residential treatment services and group home services populations are mixed, the agency documents that the clinically-based criteria have been met to address safety issues.

(4) When residential treatment services and group home services populations are mixed, the minimum staffing ratios for residential treatment services apply.

N.M. Admin. Code § 7.20.11.30

7.20.11.30 NMAC - Rp 7 NMAC 20.11.29, 03/29/02