N.D. Admin. Code 75-03-17-12

Current through Supplement No. 394, October, 2024

Section 75-03-17-12 - Discharge

1. Discharge planning for each child must begin during the admission process. The facility shall develop an evolving discharge plan within seven days of admission that identifies the child's and family's needed services and supports upon discharge and include the discharge plan in the treatment plan. The facility's interdisciplinary team shall review the discharge plan every fourteen days at the same time as the treatment plan review. The facility's interdisciplinary team shall update or amend the discharge plan to meet the needs of the child.

2. Prior to discharge, the facility shall complete a discharge plan, coordinate community services required for the child to return to the home, and provide information for aftercare services with each child's family, school, and community to ensure continuity of care. The discharge plan must address and include:

a. Psychiatric, medical, educational, psychological, social, behavioral, developmental, and chemical dependency treatment needs;

b. The reason for discharge;

c. A progress report, including an update on the child's psychiatric care and treatment recommendations;

d. An assessment of community-based service needs for the child and family;

e. A statement that the discharge plan recommendations have been reviewed with the child and the person who lawfully may act on behalf of the child;

f. The name and title of the individual into whose care the child was discharged.

3. The discharge committee shall review and approve each anticipated discharge thirty days before the discharge and provide the completed discharge plan to the custodian at least seven days before the anticipated discharge.

4. At least seven days prior to discharge a team meeting involving the child, the person who lawfully may act on behalf of the child, the facility treatment team, and related community services providers must take place to ensure the continuity of services consistent with the child's treatment needs after discharge. As part of the discharge planning requirements, facilities shall:

a. Identify a prescribing provider in the community and schedule an outpatient visit;

b. Ensure the child has a seven-day supply of needed medication and a written prescription for medication to last through the first outpatient visit in the community with a prescribing provider; and

c. Include documentation of the medication plan and arrangements for the outpatient visit in the medical records in the child's case file. If medication has been used during the child's treatment in the facility but is not needed upon discharge, the reason the medication is being discontinued must be documented in the medical records in the child's case file.

5. The discharge committee shall review and approve each discharge from a facility prior to the discharge. The discharge committee must include the following:

a. Tier 1 mental health professional;

b. Attending therapist;

c. Assigned social worker;

d. Facility nurse;

e. Facility educator;

f. Facility residential staff; and

g. A person who lawfully may act on behalf of the child.

6. The facility shall assist the child and the person who lawfully may act on behalf of the child in preparing for the transition from residential treatment to return the child home, to a foster family, adoptive family, an institution, or to the home of relatives.

7. The facility treatment team shall develop a discharge plan that ensures appropriate appointments are scheduled, based on the child's needs and input from the person who lawfully may act on behalf of the child, as part of the post discharge plan. Appointments must support continuity of care addressing needs for individual therapy, psychiatric services and educational services, and other services or supports that may be appropriate. The facility treatment team shall provide a copy of the plan to the person who lawfully may act on behalf of the child and a copy must remain in the chart.

8. If a discharge is not anticipated at least thirty calendar days ahead of time, the discharge is considered unplanned and the facility shall:

a. Hold a discharge planning meeting involving the child, custodian, parent, guardian, facility treatment team, additional family members, and any other relevant parties. This meeting must allow relevant parties time to review the discharge plan and aftercare engagement strategies while discussing services needed to best meet the needs of the child; and

b. Create and provide in writing a finalized discharge and aftercare plan to the custodian and parent or guardian at least seven days before the child's discharge.

9. A child's discharge from the facility may not be based on the child's need for short-term inpatient treatment at a psychiatric facility.

10. The facility may not discharge a child without community-based support services in place. If a child does not have a home or safe place for discharge, the facility shall work with the legal custodian or placing agency to implement a safety plan for the child until a safe place is available.

N.D. Admin Code 75-03-17-12

Amended by Administrative Rules Supplement 2014-352, April 2014, effective April 1, 2014. .

Amended by Administrative Rules Supplement 2016-360, April 2016, effective 4/1/2016.

Amended by Administrative Rules Supplement 2022-385, July 2022, effective 7/1/2022.

General Authority: NDCC 25-03.2-10

Law Implemented: NDCC 25-03.2-03, 25-03.2-07