La. Admin. Code tit. 48 § I-5549

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-5549 - Staff Composition and Organization

A. The psychiatric facility shall be responsible for evaluating and ensuring that the fundamental needs of the persons in care are provided for. To meet this responsibility, the facility shall have available the services of a sufficient number of appropriately qualified mental health professionals. These shall include but are not limited to qualified psychiatrists, qualified psychologists, and qualified social workers. When these qualified professionals are not available on a full-time basis, arrangements shall be made to obtain their services on at least a continuing consulting basis. Their authority and participation shall be such that they are able to assume professional responsibility for supervising and reviewing the needs of the individuals and the services being provided.

B. In addition, there shall be a sufficient number of other qualified mental health professionals and paraprofessionals as necessary to carry out the particular clinical programs provided by the facility and to provide quality clinical services. They include but are not limited to other physicians; child psychiatric nurses; child care workers; educators; speech, hearing, and language specialists; activity therapists, recreational therapists; and vocational counselors. There shall be an adequate number of administrative personnel to provide the necessary support for the administrative and clinical programs.

C. The composition of the staff shall be determined by the facility, based on an assessment of the needs of the persons being served, the facility's goals, the programs provided, and all applicable federal, state, and local laws and regulations. Factors to be considered in determining appropriate staff composition include (1) number of persons in care, (2) type and severity of handicap, (3) amount of time the persons are in the care of the facility, and (4) the type of program offered by the facility. Many identical or similar services or functions may be rendered competently by individuals of various professionals.

D. The facility shall develop a staffing pattern which shall provide for adequate staff coverage at all times. Special attention shall be paid to the time of day when additional attention or supervision is required, e.g., upon awakening in the morning, during meals, late afternoon play, transitions between activities and bedtime. Staffing on nights, weekends, and holidays shall be adequate to maintain continuity of programs and care. The ratio of direct-care staff shall not, however, be less than that set out in the general standards.

E. There shall be at least one direct care staff person on duty in any area of the facility where persons are present or are expected to be present.

F. The qualified professional staff shall have the responsibility for determining which staff members shall be assigned specific treatment responsibilities. Those individuals, whether professional or paraprofessional, who are assigned specific treatment responsibilities shall have training or experience and demonstrated competence, or they shall be supervised by a professional who is qualified by experience to supervise such specific treatment. Before any member of the staff is assigned responsibility for carrying out any individual or group treatment services, the qualified professional responsible for the person(s) shall develop and implement policies which will ensure adequate supervision where indicated.

G. The residential psychiatric facility shall have coverage by qualified child psychiatrists, psychiatrists or other physicians on a 24 hour basis each day of the week that the facility is in operation. The on-call physician(s) shall be readily available by phone or page. Medical care shall be available to any resident within 30 minutes. Each physician providing coverage shall have had training or experience in caring for those with mental or emotional disorders and shall be familiar with the programs of the facility and the persons residing there.

H. The facility's written staff organization plan shall delineate all clinical staff members who are assigned responsibility, on any shift, for supervision of other staff involved in direct care.

I. The facility shall have an organizational chart which specifies the relationships among the governing body, the director, the administrative staff, the clinical staff, and supporting services; their respective areas of responsibility; the lines of authority involved; and the types of formal liaison between the administrative and clinical staff. The organizational chart shall also reflect medical responsibility for the care of all individuals.

J. The administrative and clinical staff shall be organized to carry out effectively the policies and programs of the facility.

K. The organizational chart shall reflect relationships with affiliate agencies which provide services by these standards.

L. The organizational plan shall be reviewed at least annually.

La. Admin. Code tit. 48, § I-5549

Promulgated by the Department of Health and Human Resources, Office of the Secretary, Division of Licensing and Certification, LR 13:246 (April 1987).

AUTHORITY NOTE: Promulgated in accordance with R.S. 46:1971 through 1980.