P.R. Laws tit. 24, § 6159z
(a) Purposes. — Live-in treatment for minors is a treatment modality sub-specialized in the area of child and adolescent mental healthcare, designed specifically for minors with mental health conditions which are difficult to manage at their homes or in their communities, who, despite adequate management by parents or legal guardians, have failed to respond to less restrictive levels of treatment provided by child and adolescent mental healthcare professionals. This treatment modality integrates clinical and therapeutic services organized and supervised by an interdisciplinary team within an ongoing structured setting, day and night, twenty-four (24) hours a day, seven (7) days a week. The main function thereof is to promote, strengthen, and restore adaptive functioning in youths and their families, at their homes and their communities, so that they may come back home and to their communities and continue their treatment at a less intensive and less restrictive level. This treatment modality shall be covered by health plans in the event such treatment applies.
(b) Objectives. — Vis-à-vis the restrictive nature of this treatment modality, such treatment modality shall not be employed as a first-instance therapeutic intervention on minors who have not received previous mental healthcare treatment or when such treatment has not been administered correctly by the minors’ parents or legal guardians, unless a psychiatric evaluation conducted by a child and adolescent psychiatrist shows and such psychiatrist believes and recommends that the best treatment alternative for such minors is this service, and such minors meet the criteria for being placed in such treatment.
The objectives of live-in treatment programs for minors are:
(1) To strengthen the family’s functionality so as to improve effective communication skills and interaction styles between and among its members.
(2) To develop adaptive and functionality skills of youths in their way of relating to their family, their community, and the various social institutions.
(3) To foster the development of vocational or occupational skills in order for youths to function to the best of their ability within their environment.
(4) To foster the development of skills to manage and curb mental and emotional condition-related symptoms.
(5) To foster the development of adaptive behavior skills, as well as problem management and solving skills.
(6) To foster the development of social skill management so as to allow their reintegration into society.
(7) To coordinate services with other community agencies which suit the needs of youths and their families.
(8) To develop training and workshops that focus on the prevention, management, and treatment of mental disorders in youths.
(c) Treatment. — Institutional providers of transitional services shall provide, at the very least, the following:
(1) Individualized treatment, recovery and rehabilitation, focusing on the objectives set forth in subsection (b) of this section.
(2) An adequate coordination with government and private agencies in order to successfully implement comprehensive services for minors and their families, conducive to the return of such minors to their homes and their communities.
(3) Proper care of the physical and mental health conditions of minors placed therein.
(4) Integration of families into the minors’ individualized treatment, recovery and rehabilitation plan and guidance on the matter.
(5) A balanced diet that suits the physiological needs of minors.
(6) A recreational, educational or vocational rehabilitation plan, whichever modality applies, to be instituted within the program by the interdisciplinary team.
(d) Levels or stages. — Live-in treatment programs for minors shall be developed by progress levels or stages, in order to enable the minor’s evaluation, classification, and reclassification as per his/her clinical progress, within the therapeutically indicated setting that accords the greatest autonomy possible.
The levels or stages adopted by the institution that offers the live-in treatment program for minors shall be designed to conform to the severity of symptoms and signs, the diagnosis, and the degree of supervision required by the minor, to wit, the greatest supervision, the moderate supervision, and the minimal supervision level or stage.
(e) Service manuals. — All institutional providers of live-in treatment programs for minors shall issue a service manual, which shall state, at the very least, the following:
(1) The philosophy, mission, and objectives of the Program.
(2) A description of the Program and its stages or levels.
(3) The criteria for placement to be met by minors when placed in the Program.
(4) Criteria for preclusion from the Program.
(5) The composition of the institution’s personnel and their qualifications.
(6) The treatment and ancillary service modalities provided by the Program.
(7) The age, gender, diagnosis, and functionality level.
(8) An individualized treatment, recovery and rehabilitation plan prepared by an interdisciplinary team.
History —Oct. 2, 2000, No. 408, added as § 9.01(A) on Aug. 6, 2008, No. 183, § 50.