Facility-Based Care for Children with Intellectual Disabilities and/or Autism Spectrum
DIAGNOSIS AND INPATIENT ADMISSION CRITERIA
The Specialized Needs Unit delivers an array of services to youth with an acute mental health diagnosis who are diagnosed on the Autism Spectrum or have a developmental, intellectual, congenital, or acquired disorder.Please Click Here to Complete and Download the Special Needs Unit/Autism Program Referral Form.
The program is appropriate for individuals age 8 to 17 who present the following:
- A wide variety of psychiatric disorders
- An appropriate diagnosis on the Autism Spectrum and/or Intellectual Disorders
- Intellectual limitations resulting in psychological and/or behavioral impairment
- Potential danger to self and/or others
- Impaired functioning attributable to the disorder, which is of sufficient intensity to interfere substantially with ordinary demands of the environment, including social, familial, educational, or occupational functioning self-care.
- Ambulatory and, if applicable, any existing medical condition is stabilized. (Note: The same, standard Ambulation and medical criteria that applies to a free-standing behavioral health hospital also applies to the SNU).
SPECIAL NEEDS UNIT PROGRAM DESIGN
Clinical Philosophy and Treatment Approach
Our patients are approached using a biopsychosocial formulation. All available information is reviewed from outside resources as well as from staff at the facility. Patients are assessed from multiple disciplines to help formulate an initial treatment plan and then continue to be regularly reassessed by the treatment team during the patient’s stay.
The inpatient services provided include a combination of the following, as deemed medically necessary for treatment effectiveness:
- Psychiatric Evaluation, Supervision, Medication Management, and Intervention
- Internal Medicine Evaluation and/or Care
- Speech Language Pathology
- Occupational Therapy
- Social Work Intervention & Discharge Planning
- Medication Administration and Monitoring
- Behavior Stabilization and Modification
- Behavior Analysis and Verbal Behavior Programming
- Sensory Integrative Therapy
- Functional Behavioral Assessments/Interviewing
- Assistance with activities of daily functioning
- Data taking, analyzing, and tracking
- Functional Skill Development
- Individualized/Group Psychotherapy
- Therapeutic Milieu
- Adjunctive Therapy: Expressive Arts, Equine/Animal Assisted Therapy and Activity Therapeutic Intervention
- Individual/Family Psychotherapeutic Intervention
- Individualized Family Training
- 24/7 Nursing Care
Special Needs Unit Configuration
The SNU contains 18 beds. Rooms are double occupancy with the option to offer a single room if necessary and on availability. In addition, the unit provides:
- Nursing station
- Medication room
- Day room
- Group therapy room
- Outdoor courtyard area
- Adequate hallway space
- Laundry facilities
- Seclusion and restraint room
- Low sensory room
- High sensory room
- Consult and behavioral observation room
Psychiatrist: Directs medical care and medication management for each patient.
Registered Nurses: Provides daily nursing care for each patient; dispense medications; assess the efficacy of the care given to the patient.
Registered/ Behavioral Health Technicians (RBT/BHT): Assists with hygiene, meals, activities, behavioral plan implementation, clinical programming and unit protocols.
Behavior Analysts (BCBAs): Assess challenging behaviors and environmental factors through a series of initial assessments, data collection, functional analysis testing, and patient/family interviews. Analysts will develop behavior plans based on individual patient needs, contribute/guide treatment interventions, and implement interventions for behavior reduction and skill acquisition.
Patient Care Manager (PCM)/Clinical Therapist: Conducts psychosocial assessments, treatment planning, individual/group therapy, family therapy sessions, parent/guardian psychoeducation sessions and discharge planning/coordination of care with outpatient service providers.
Adjunctive Therapists: Provides expressive therapies such as art, music, movement/exercise, sensory interventions; coordinates activities and group. Work to increase independence in functional living skills.
Related Service Professionals: Includes: Speech-Language Pathologist, Dietician, Occupational, Physical and Recreational Therapists who provide expressive and adaptive therapies such as sensory interventions as needed to increase independence in functional living skills.
The staffing and acuity plan is the hospital’s method for establishing nursing personnel requirements needed to meet the patient needs and acuity. Appropriate staffing requirements are based on a review of the current patient population, individual safety needs, historical and projected data, department specific quality indicators and therapeutic goals. Each unit has a predetermined patient to staff ratio used as a guideline.
Staffing for patient care is based on individual patient acuity, which is assessed every shift. This ensures optimal care for the patient(s) and ensures patient and staff safety. Acuity based staffing achieves the following:
- Meets the individual patient's needs
- Provides optimal patient care
- Ensures patient and personal safety
- Provide a framework for nursing staff to evaluate the nurse-to-patient ratio and nursing level care as needed
Evaluation and Assessment:
- RN Nursing, which includes pain, suicide risk, vulnerability, fall risk, AWOL risk, sexual acting out, danger to others risk, review of systems and dietary screening – as soon as possible within 8 hours of admission.
- Psychiatric Evaluation – within 24 hours of Admission
- History and Physical Examination – within 24 hours of admission
- Psychosocial Assessment - within 24 hours of admission
- Adjunctive Therapy Assessment – within 48 hours of admission
DPBHH plans to offer two milieus on the proposed unit. One milieu is designed to address the needs of low functioning, non-verbal patients; the second milieu will be designed to serve higher functioning patients. This allows us the ability for a fluid staffing model based on acuity levels and cognitive abilities.