Committee discusses PRTF rates, basic care facilities and licensing changes to address behavioral‑health needs

Committee members and department staff reviewed the distinctions between psychiatric residential treatment facilities and basic care/adult residential facilities, and discussed regulatory and payment options to better serve residents with behavioral‑health needs.

Sarah Aker described PRTFs as an intensive, short‑term treatment setting where "people are expected to discharge, start discharging, or planning for discharge day 1 they enter into a PRTF," noting PRTFs have tighter programmatic standards and a distinct rate‑setting process. By contrast, staff told the committee that basic care is intended to be "someone's home" and historically has provided personal care services and room and board funded by a mix of state plan services and state general funds.

Staff said basic care settings increasingly serve people with behavioral‑health needs and that there are not universal requirements for behavioral‑health program outcomes in basic care. The department said its basic‑care study recommends a possible path forward: consolidating licensing across assisted living, basic care and adult residential settings so facilities could choose populations to serve under a single licensure, simplify rules for families, and create a clearer pathway for integrating home‑and‑community‑based (HCBS) supports.

Committee members raised concerns about large congregate settings with many psychiatric patients and potential Olmstead considerations around the least‑restrictive environment. A staff presentation scheduled for the next day will cover PRTF rate setting, budget information, and an exploration of value‑based approaches to rates.

Next steps: the department will present a fuller basic‑care study and PRTF briefing at the next committee meeting; members suggested the department draft options for licensure consolidation and criteria for facilities serving higher behavioral‑health‑acuity residents.