(1) PRTF services must include active treatment designed to achieve the discharge of the youth to a less restrictive level of care at the earliest possible time. Active treatment includes, but is not limited to, the following services provided regularly and as clinically indicated:

(a) individual psychotherapy;

(b) group psychotherapy; and

(c) family therapy.

(2) PRTF services must be provided under the direction of a licensed physician.

(3) A PRTF must submit a request for an eligibility determination to the department's developmental disability program (DDP) for youth suspected of having a developmental disability if a request has not already been made for youth 8 to 18 years of age. An eligibility determination for adult services may be requested for youth 16 years or older.

(a) the PRTF must complete and submit to the DDP a cover letter along with the psychological testing and assessments required by the DDP; and

(b) the PRTF must complete and submit additional documentation, if requested by the DDP.

(4) The PRTF must use the Montana children and adolescent needs and strengths (MT-CANS) functional assessment for youth on admission and prior to discharge to assist in the development of the plan of care and the discharge plan.

(5) The PRTF plan of care must be comprehensive and address all psychiatric, medical, educational, psychological, social, behavioral, and developmental treatment needs.

(6) The plan of care and discharge plan for the youth must be reviewed at least every 30 days at the multidisciplinary treatment team meeting, and more frequently if there is a significant change in the condition of the youth. The parent or legal representative of the youth must be invited to participate in these meetings, and given adequate notice to participate. Adequate notice means generally a week unless the condition of the youth dictates otherwise. At a minimum the following must be discussed, if applicable to the needs of the youth:

(a) diagnosis or changes to diagnosis;

(b) mental status or changes to mental status;

(c) medication use, purpose, and any changes;

(d) treatment goals of the youth, progress or lack of progress, and revisions to the treatment plan;

(e) risk behaviors and the use of special treatment procedures;

(f) co-occurring issues that impact treatment of the youth, such as developmental or cognitive delays, substance use disorder, and sexual reactivity or offending;

(g) individual, group, and family therapy outcomes; and

(h) readiness for discharge of the youth, specific services needed on discharge, and who will be making the appointments for discharge services.

(7) PRTF services include only treatment or services provided in accordance with all applicable licensure, certification, and accreditation requirements, and these rules.

(8) In addition to the other requirements in this rule that pertain to discharge planning the following activities are required. The PRTF must:

(a) identify the community to which the youth will discharge;

(b) develop a discharge plan within 30 days of admission that identifies the youth and family's needed services and supports upon discharge:

(i) the discharge plan must address psychiatric, medical, educational, psychological, social, behavioral, developmental, and chemical dependency treatment needs, as appropriate.

(c) make appointments for needed services and supports upon discharge, no less than seven days before discharge; and

(d) work with the parent or legal representative of the youth independently, or for out-of-state PRTFs, with a targeted case manager, in making agreed upon discharge plans and referrals for needed services.

(e) provide targeted case management services according to the limitations in ARM 37.87.1223, as needed.

(9) If appropriate arrangements for services upon discharge are not made as required in (6) the PRTF may be at risk of losing its enrollment in the Montana Medicaid program.

(10) As part of the discharge planning requirements, PRTFs must ensure the youth 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. Prior to discharge, the PRTF must identify a prescribing provider in the community and schedule an outpatient visit. Documentation of the medication plan and arrangements for the outpatient visit must be included in the medical record for the youth. If medication has been used during the PRTF treatment of the youth, but is not needed upon discharge, the reason the medication is being discontinued must be documented in the medical record for the youth.