How to Open an IRTS Facility

 

 

What is an IRTS facility?

An intensive residential treatment services (IRTS) facility provides mental health services to adults while they concurrently live at the facility. IRTS programs provide services that help individuals stabilize a person’s mental health, become more adjusted to daily life and self-sufficiency, and teach skills to live more independently.

Click here to go to the Minnesota DHS page for Adult Mental Health Residential Services.

Click here to go to the Minnesota DHS page for IRTS.

 

What types of clients does an IRTS facility serve?

Adults who require a level of care, due to their mental illness, that is medically monitored, 24 hours a day are eligible for an IRTS facility. IRTS clients also must meet other criteria such as having functional impairment in multiple areas due to their mental illness, homelessness, or a history of recurring inpatient hospitalizations in the past year. IRTS is not a long-term, permanent placement for clients, but rather more of a stabilization phase where services are provided that encourage and facilitate independence.

 

What types of properties qualify to be an IRTS facility?

An IRTS facility could be a residential home or an apartment type setting.

Program locations for IRTS facilities must meet the following criteria:

• The rooms must be physically self-contained and have defining walls extending from floor to ceiling;
• The facility must include bedrooms, living rooms or lounge areas, bathrooms, and connecting areas;
• The facility must have one living room or lounge area per program location if there are multiple locations;
• The facility must have space available to provide services according to each client’s treatment plan, such as an area for learning recreation time skills and areas for learning independent living skills, such as doing laundry and cooking;
• The capacity must be between five and 16 beds and cannot be declared as an institution for mental disease;
• The facility must furnish the program to meet the psychological, emotional, and developmental needs of clients;
• The program must ensure that each location, if there are multiple locations, allows each client to have privacy during certain treatment services such as assessment interviews or counseling sessions. These private spaces to deliver IRTS services cannot also be categorized as a living room or lounge for the purposes of the facility requirements;
• Each client must have a space designated for the client to see outside visitors at the program facility. A bedroom that is not shared would meet this requirement.

 

Additional considerations for the facility:

• There must be space for employees to have a break area and a bathroom;
• If the program offices are going to be on site, they need to be separate from residential spaces.
• There must be a bathroom on each level that is inhabited and the ratio of residents to bathrooms cannot exceed one to eight.
• DHS will allow variances to some their requirements, such as not requiring commercial cooking equipment if there are ten or less residents.
• If you have six or less residents, you are not required to have fire sprinklers if the facility is less than 4500 sqft. If you have 7-16 residents, fire sprinklers are required, regardless of the square footage of the facility.
• If you have seven or more residents, at least one of the bathrooms must be handicap accessible, according to ADA standards.

 

What is required to open an IRTS facility?

DHS requires that before a future program can be licensed as an IRTS facility, they must have a location to open their program that meets requirements and separate state licenses, however, because the Minnesota Department of Health asks for license information on their applications, it is important to have started the license process with DHS so a contact person can be provided to the Department of Health. The application process for the facility can be done concurrently with the application for the IRTS program.

 

What are the facility or real estate requirements to open an IRTS program?

1. Obtain a Supervised Living Facility license or a Board and Lodge Facility license from the Minnesota Department of Health.
2. Comply with all applicable building, fire, and safety codes; health rules; zoning ordinances, and other applicable rules and regulations. Contact the city and county of the building/home/real estate you are interested in to make sure that zoning ordinances allow for an IRTS facility.

The best way to do this is to call City Hall in the city or suburb you are looking at for your IRTS facility and find out if there are any restrictions on adult supervised living facilities.

 

 

What are the staffing requirements to open an IRTS facility?

The bare minimum staff that are required to obtain a DHS license to be an IRTS provider are:

1. Program Director (qualifies at minimum as a mental health practitioner)

To qualify as a Mental Health Practitioner, one must meet a combination of education and work experience requirements, only work experience requirements, only education requirements, or a combination of work experience and treatment supervision requirements.

Click here for a detailed list of qualifications for mental health practitioners.

1. Treatment Director (mental health professional)

A Mental Health Professional could be an LICSW, LPCC, advanced practice registered nurse, physician, psychologist, etc.

Click here for a detailed list of qualifications for mental health professionals.

1. Registered Nurse (qualified as a mental health practitioner at the program at least eight hours per week)

One person can qualify and meet the requirements for two of these roles. For example, the program director could also be the registered nurse, or the treatment director could also be the registered nurse, if they had the additional certifications or training to be qualified as a mental health professional.

Additional staff that can be hired on once the program is licensed or grows:

• Mental health professional
• Certified rehabilitation specialist
• Clinical trainee
• Mental health practitioner
• Mental health rehabilitation worker
• Mental health certified peer specialist

 

 

What is a Supervised Living Facility license?

A supervised living facility, with a DHS license for counseling and developmental habilitative or rehabilitative services, provides supervision, lodging, meals, and services. Supervised living facilities serve five or more residents who are developmentally disabled, chemically dependent, adult mentally ill, or physically disabled.

 

 

How do I register as a Supervised Living Facility?

1. Complete the license application on the Minnesota Department of Health for a supervised living facility.
2. There are two different “Classes” of supervised living facilities. An IRTS facility is categorized as a Class A facility because the residents are ambulatory and mobile persons who are capable of taking appropriate action for self-preservation under emergency conditions. (Minn. Rules 4665.0500) Although not required to fill out on the application, it is important to note the distinction between a Class A-1 facility and a Class A-2 facility because there are different building code requirements for the two different classes.

Class A-1: Has 6 or fewer residents;

Class A-2: Has 7 to 16 residents.

Click here for the link to the MN Department of Health license application to operate a supervised living facility.

 

 

What is a Board and Lodge Facility with Special Services?

A board and Lodge facility serves five or more persons and provides case, both personal and custodial, to its residents that includes, but is not limited to, assistance with eating, grooming and activities of daily living. These facilities also provide supervision of self-administered medications and may provide nursing care, but do not have to. The population of a board and lodge facility with special services is individuals who are not acutely ill, but are elderly or have a physical disability or mental illness.

**Currently there is a moratorium that prohibits the commissioner of health from certifying new beds in boarding care homes. So, until this is lifted, while ultimately this is an option for an IRTS facility, it is currently not a viable option.**

 

How do I register as a Board and Lodge Facility with Special Services?

1. Be licensed as a Boarding and Lodging or Lodging Establishment.
2. Register to provide special services which registers the facility to be able to provide nursing services.
3. Obtain a Food, Beverage, and Lodging Establishments License through the Food, Pools and Lodging Services Section of the Environmental Health Division at the Minnesota Department of Health (MDH).

 

Click here for the link to the MN Department of Health registration form for Board and Lodging Establishments with Special Services.

 

 

Other Helpful Resources to Check Out:

Click here for the DHS application for an IRTS facility.

Click here for the Minnesota Rules that govern Space Arrangements and Requirements for an IRTS facility.

Click here for the MN Quick Reference Guide to Care Facilities that contains some building and fire codes.