Program Guidance for Contract Deliverables Incorporated Document 8

Transcription

1 Requirement: Frequency: Due Date: Forensic and Civil Treatment Facility Admission and Discharge Processes Chapter 394, F.S. Chapter 916, F.S. Chapter 65E 4.014, F.S. Chapter 65E 4.016, F.A.C. Chapter 65E 5, F.A.C. Chapter 65E 12, F.A.C. Children and Families Operating Procedures (CFOP) , 17, 18, 19, 22, 38, 48 Ongoing N/A CIVIL ADMISSION AND DISCHARGE Section , F.S., requires the Department to implement a continuity of care management system to provide mental health care for individuals referred from State Mental Health Treatment Facility (SMHTF) to the community. To comply with Section , F.S. the Managing Entity will contract with Network Service Providers to provide case management services for each civil resident of a SMHTF whose home county is within the Managing Entity geographic service area. These services may be provided by a community case manager, a Florida Assertive Community Treatment (FACT) team member, or other designated community Network Service Provider staff. The Managing Entity shall ensure the following activities are performed for individuals transferring into or out of state mental health treatment facilities: (1) A client s case will remain open during the time the client resides at a state treatment facility. (2) The case manager, or other assigned community behavioral health staff member, shall: a. Participate in the development of a SMHTF treatment plan. b. Maintain at least monthly contact with state treatment facility staff concerning the status of the individual. c. Maintain contact with the individual s family consistent with Chapter 394, F.S. d. Share relevant information with the SMHTF staff. e. Participate in the discharge planning meeting and assist in the development of a service plan which addresses the individual s needs in the community. f. Actively carry out linkage and brokerage activities in the community prior to the individual s discharge in order to implement the service plan. g. Have a face to face contact with the client in the community within 2 working days of discharge from the SMHTF. h. Maintain progress notes in the client record reflecting all meetings and communications with state treatment facility staff, the client, the family or significant others. i. Maintain progress notes in the client record reflecting all meetings and communications with state treatment facility staff, the client, the family or significant others. Updated 8/01/2017, Page 1

2 j. In addition to the above responsibilities, the civil Network Service Providers shall submit the participation tracking report to the state hospital contact person at the Managing Entity by the 10 th of each month. PRIORITY INDIVIDUALS I. Case Management Services II. The Managing Entity shall ensure that the following Priority individuals are eligible to receive, and are offered Case Management Services as described in 65E 4.014, F.A.C: a. Persons who are being admitted to a SMHTF or are awaiting admission to a SMHTF; b. Persons who are in a SMHTF regardless of admission date; c. Persons who have moved into a Region from another Region where they had been receiving case management; d. Persons who are at risk of institutionalization or incarceration for mental health reasons; e. Persons who have been discharged from a SMHTF; f. Persons who have had one or more admissions to a crisis stabilization unit (CSU), shortterm residential facility (SRT), or inpatient psychiatric unit; g. Persons who reside or have been discharged from a mental health residential treatment facility (RTF); h. Persons who are experiencing long term or serious acute episodes of mental impairment that may put them at risk of requiring more intensive services. Intensive Case Management Services The Managing Entity shall ensure that the following Priority individuals are eligible to receive, and are offered Intensive Case Management Services, within existing resources, as described in 65E 4.014, F.A.C. a. Persons who have resided in a SMHTF for at least 6 months in the last 36 months; b. Persons who reside in the community and have had two or more admissions to a SMHTF in the last 36 months; c. Persons who reside in the community and have had three or more admissions to a crisis stabilization unit (CSU), short term residential facility (SRT) or inpatient psychiatric unit within the last 12 months; d. Persons who reside in the community and, due to a mental illness, exhibits or would exhibit behavior or symptomatology which could result in long term hospitalization if frequent interventions for an extended period of time were not provided. Continuity of Care I. Admission to a SMHTF Chapter 65E , F.A.C., requires a community mental health center or clinic shall evaluate each person seeking voluntary admission to a state treatment facility and each person for whom Updated 8/01/2017, Page 2

3 involuntary placement in a state treatment facility is sought, to determine and document: (a) Whether the person meets the statutory criteria for admission to a state treatment facility; and (b) Whether there are appropriate more integrated and less restrictive mental health treatment resources available to meet the person s needs. When petitioning a consumer to the state hospital the Receiving Facility provider shall: Send the referral packet to the SMHTF and copy the Managing Entity (ME;) Notify the ME when the consumer has been placed on the wait list; Notify the ME when the consumer is transported to the SMHTF; Only when necessary, re evaluate the consumer s stability every two (2) weeks while waiting for a bed at the SMHTF; The ME will refer all consumers awaiting admission to the local FACT team for screening. Case Managers should make first contact with consumers who are waiting for admission to SMHTF so that consumers are familiar with them prior to admission. II. Discharge from a State Mental Health Treatment Facility It is the responsibility of the Network Service Provider s community case manager(s) for residents committed pursuant to Chapter 394, F.S., to participate in the development of the discharge plan and identify services and supports needed for the resident s discharge. The Managing Entity shall ensure that the contracted Network Service Providers that provide community case management services: a. Secure community placement and services in cooperation with SMHTF social worker or discharge planner, b. Maintain contact with the facility case manager and Social Worker, and c. Ensure recommended services are received after the individual s discharge. Each SMHTF maintains a Seeking Placement List (SPL) of all civil residents who no longer meet criteria for civil commitment and who are actively seeking placement in the community. The Seeking Placement List will be sent by the SMTHF to the Managing Entity each month. The Managing Entity will send each provider their list of discharge ready individuals. The NSP is then responsible for completing a community barriers checklist for each individual on discharge status and returning that checklist to the Managing Entity contact person by the end of the same month. For each individual who is placed on discharge status after receipt of the Seeking Placement List, the provider must complete a community barriers checklist during the month the individual s 20 th days on discharge status falls. (Example: The 7001 form for Jane Doe was completed and sent to the Managing Entity and provider on September 20. This means Jane Doe s 20 th day on discharge status would fall in October; the community barriers checklist would then be due to the Managing Entity by the end of October). The community case manager should continue to work with facility staff to develop discharge plans for those on the SPL awaiting community placement. The Managing Entity will provide oversight to ensure the Network Service Provider is maintaining compliance with the aforementioned community case manager responsibilities identified herein and as referenced in the Department CFOPs. Updated 8/01/2017, Page 3

4 Upon discharge from a SMHTF, the client will be assigned a case manager to follow him/her in the community regardless of benefit status. FORENSIC Chapter 916, F.S., requires the Department to establish and maintain separate and secure forensic facilities and programs for the treatment or training of defendants who have been charged with a felony and who have been found to be incompetent to proceed (ITP) due to their mental illness or who have been acquitted of a felony by reason of insanity (NGI). I. Criteria for Admission to a Forensic Facility A. Forensic facilities admit individuals who are mentally ill and who have been committed to the Department pursuant to Chapter 916, F.S., and: i. Have been determined to need treatment for a mental illness; ii. iii. iv. Have been found incompetent to proceed on a felony offense or have been acquitted of a felony offense by reason of insanity; Have been determined by the Department to: a. be dangerous to themselves or others; or b. present a clear and present potential to escape; and Who are adults or juveniles prosecuted as adults. II. Discharge from a SMHTF A. ITP discharges include individuals restored to competency, five year ITPs with dismissed charges, non restorable (Mosher) discharges, conditional release discharges; B. NGI discharges include individuals conditionally released, those released by the court without conditions, those with jurisdiction terminated. The Forensic Mental Health Services Model found in CFOP details forensic responsibilities of the Network Service Provider. The Network Service Provider is to designate Forensic Specialists and other staff to work on forensic mental health issues with forensic mental health clients. Specific to Forensic Mental Health Services, the Network Service Provider shall: Comply with CFOP and ensure all required documentation listed therein is submitted on a monthly basis. Provide the state treatment facility(ies) with all available community information required to assist with the individual s treatment. Work consistently with the state treatment facility staff to ensure an individual with forensic involvement is placed in the least restrictive environment in a timely manner. Conduct a minimum of quarterly meetings with individuals at the state treatment facility(ies) or civil step down treatment facility(ies), including assistance with discharge planning. Representatives from the Network Service Provider shall be actively involved in the discharge process and shall assist with finding a living environment and identify community services that will support the level of need. Updated 8/01/2017, Page 4

5 Locate appropriate community placements in a timely manner. Locate appropriate community placements and arrange for needed aftercare services for individuals determined appropriate for discharge. Intervene when necessary to resolve issues among stakeholders to ensure the process moves forward in a timely manner. Assist the treatment facilities and appropriate court personnel in the development of conditional release plans. Attend all conditional release hearings. Work closely with the state forensic and civil treatment facility(ies), local mental health providers, crisis stabilization units (CSU) and the courts to ensure the appropriate and timely disposition of individuals not found competent within five years. Provide or ensure the provision of information to the Courts and the attorneys pertaining to the individual s treatment in the state treatment facility(ies) as requested. Provide treatment facility staff information regarding housing options for forensic and/or prospective individuals. Upon discharge from a SMHTF, each consumer must be assigned a case manager to follow him/her in the community regardless of benefit status. Consumers discharged from the SMHTF to an SRT are required to be case managed by their primary community mental health provider. SRTs are meant to be time limited transitional beds. It is the community case manager s responsibility to locate and secure long term community placement. In addition, it is the community case manager s responsibility to connect the consumer to needed community services, community supports and actively engage in monthly treatment team meetings while the consumer is residing in the SRT. In addition to the above responsibilities, the forensic Network Service Providers should submit the forensic participation tracking report to the forensic coordinator and the Network Manager at the Managing Entity by the 10 th of each month. Updated 8/01/2017, Page 5