AGENCY NAME - Crisis Stabilization Services

Transcription

1 AGENCY NAME - Crisis Stabilizatin Services Prgram Statement Crisis stabilizatin services are prvided t children and adlescents ages 6-17 that have symptms and current presentatin that requires skilled prfessinal staff t address their needs. Crisis Stabilizatin services will be prvided by the prgram fr a maximum f 5 days. This service is designed as an interventin that seeks t stabilize the child and/r family s situatin when the current crisis situatin warrants the additinal level f service as nted abve. Prgram Ntificatin Child Placing Agencies with a histry f making referrals t the prvider agency will be ntified that Crisis Stabilizatin Services will be prvided within the facility. New referring agents will be ntified f the prvisin f Crisis Stabilizatin Services. Referral Prcess Step 1: The cmmunity-based crisis services prvider (cunty r agent f the cunty) will cmplete a crisis assessment that includes a respnse plan. Step 2: If the cnsumer s respnse plan includes the need fr vluntary crisis stabilizatin services, then the entity cmpleting the crisis assessment will prvide clinical infrmatin t the stabilizatin prvider in rder fr the prvider t determine medical necessity and apprpriateness fr the vluntary crisis stabilizatin services at their facility. Nte: The cunty and guardian authrize the use f the vluntary crisis stabilizatin services. Step 3: At the time f referral cntact, the crisis stabilizatin prvider will cmplete an admissin screening (gather clinical infrmatin) t determine client s apprpriateness fr the crisis stabilizatin services. Additinally, clients will be admitted based n their cmpatibility with current residents in the prgram t ensure that each individual s needs can be met by the prgram. The prgram must prvide staffing t meet the needs f the child. Admissins Children cnsidered apprpriate fr the crisis stabilizatin services are yuth between the age f 6 and 17. Stabilizatin services are shrt term, intensive services t children underging a mental health crisis and used t stabilize a child s behavir. The stabilizatin services shall be prvided with the purpse f achieving ne r mre f the fllwing utcmes: a. Reducing r eliminating an individual s symptms f mental illness s that the persn des nt need inpatient hspitalizatin. b. Assisting in the transitin t a less restrictive placement r living arrangement when the crisis has passed. Medicaid Guidelines indicate that the fllwing factrs supprt cntinued Crisis Stabilizatin services: 1

2 Cntinued risk f self- harm Cntinued risk f harm t thers Impaired functining due t symptms f md and / r thught disrder Recent failure f less restrictive ptins (independent living, cmmunity supprt prgram, grup living) Lack f available /effective supprts (including family) t maintain functining and safety (e.g. If supprts are withdrawn, the persn wuld be at high risk fr relapse which wuld lead t mre restrictive placement ) Need fr intensive mnitring f symptms and/r respnse t recent medicatin change Recent histry f the abve that supprts the belief that if supprts are withdrawn risk fr mre restrictive setting wuld be imminent Nte: The prvider s dcumentatin shuld supprt the abve. If the cnsumer des nt meet ne f the abve, then interventins shuld be cded as nn-billable. The cmpleted dcumentatin will be placed in the client chart. Additinally, clients will be admitted based n their cmpatibility with current residents in the prgram t ensure that each individual s needs can be met by the prgram. AGENCY NAME Prgram Directr, Assistant Directr, r a specifically assigned supervisr shall review ptential resident s referral infrmatin. If the infrmatin des nt cntain r clarify treatment issues/presenting prblems adequate t determine apprpriateness fr crisis stabilizatin services, the referring agent will be cntacted fr this infrmatin. In sme cases, a representative f the AGENCY NAME prgram may be required t interview ptential referrals t finalize a determinatin. During the referral prcess all pertinent medical infrmatin shuld be included in the scial histry gathering prcess. Recrds regarding significant medical, behaviral, dietary r emtinal cncerns, as well as current medicatins will be gathered and referenced at the time f admissin. This infrmatin is included in the stabilizatin packet prvided by the cunty t the child and his/her guardian. The child and his/her guardian shall cmplete an admissins agreement fr crisis stabilizatin services. This agreement shall evidence infrmed cnsent. A medicatin sheet will be cmpleted at intake fr all medicatins the client is currently taking, including psychtrpic and ver-the-cunter medicatins. The sheet must include the fllwing infrmatin: the name f the resident, the current mnth and year, the name and strength f the medicatin, times given. A signature at the bttm f all medicatin sheets is als required. A Medical Health Recrd Face Sheet will be cmpleted fr each resident. Clients admitted t the AGENCY NAME prgram fr crisis stabilizatin services will be screened by qualified staff using a suicide risk assessment. Other services may be accessed based n individual and family needs. 2

3 Crisis Stabilizatin Admissins Paperwrk The cmmunity-based assessment cmpleted by the cunty r their agent will assess the child s immediate behaviral and mental health needs. The specific admissins frms cmpleted will identify that the child is being admitted fr crisis stabilizatin services. AGENCY NAME staff shall ensure that all f the fllwing frms are cmpleted by parent/guardian prir t the intake f a child int the respite services prgram. Vluntary Crisis Stabilizatin Admissins Agreement will cver the fllwing: Guardian respnsibility fr the csts f the Stabilizatin Services Infrmed Cnsent Patient Rights Cnsent t participate in services Medical Services and Emergency Cnsent Medicatin Distributin Cnsent Current medicatins in their riginal cntainer Stabilizatin Services Face Sheet will cver the fllwing: Necessary cntact infrmatin Medical histry/ health cncerns Mental Health Histry Trauma Histry Other special needs Vluntary Crisis Stabilizatin Services Agreement will cver the fllwing: Infrmed Cnsent Cst f Crisis Stabilizatin Services Releases will be btained fr the crdinating cunty and the ther service prviders actively wrking with the child. The child shuld bring with them t crisis stabilizatin services: Any prescribed medicatins in their riginal cntainers. Clthing. Schl materials. Client Orientatin 3

4 Staff receiving a child at intake fr crisis stabilizatin shall prvide a review f huse rules, tur f facility, verview f resident s rights, and assist in child s adjustment t placement. All resident s persnal pssessins and clthing items are reviewed and recrded upn admissin. Resident s with insufficient clthing shall receive clthing that fulfills the basic maintenance requirements fr full participatin in prgramming, when apprpriate/applicable. The Client Intake Packet will be reviewed and includes: Written infrmatin f resident rights and review verbally. Dcumentatin f all belngings brught int facility. Review huse rules. Identificatin f Emergency Exits. The structure f the AGENCY NAME prgram may allw fr crisis stabilizatin clients t participate in the daily milieu and activities f residential prgram clients. The determinatin t have the child participate will be made based n the child s individual needs at the time f stabilizatin. The prgram cmpnents include an educatinal and vcatinal prgram, recreatinal activities and structured grups designed t develp psitive cping skills, cmmunicatin skills and teambuilding. In specialized crisis stabilizatin situatins requiring mre individualized prgramming, arrangements will be made t ffer activities supprtive f the child s needs. Fr example, if a stabilizatin child is nt apprpriate t participate in AODA grup, staff might wrk ne n ne with him in rle-playing situatins and develping prblem slving skills. Crisis Stabilizatin Services Staff Qualificatins Crisis stabilizatin staff will be qualified resident care wrkers and the prgram will maintain a staff t client rati that meets the needs f the children served. Crisis stabilizatin clients will participate in scheduled daily activities including educatinal services, recreatinal services, and therapeutic milieu accrding t their ability and need. New emplyees wrking in the prgram (in a direct care capacity) are required t cmplete 80 hurs f supervised training in varius cmpnents f the AGENCY NAME prgram. The rientatin may include the fllwing cmpnents: Cmplete persnnel infrmatin with prgram supervisr Patients Rights with prgram supervisr Review intake packet with day supervisr Review all resident frms used and be advised f all emergency prcedures with day supervisr Alarm prcedures with day supervisr Observe day and evening structure Watch bld brne pathgens vide Behavir management tls and philsphy with day supervisr 4

5 Develpmental Care Creating a therapeutic milieu Human sexuality Teamwrk Wrking with Grups Sensitivity t racial and cultural differences amng residents Read examples f charting and behaviral assessments then review with evening supervisr Physical Interventin/denial f rights with prgram supervisr Run/suicide risk prcedures with evening supervisr Cmputer prcedures with evening supervisr Cmplete charting n ne resident Review plicy & prcedure manual and resident rights with supervisr In additin t the trainings nted abve, staff prviding crisis stabilizatin may be trained in the fllwing as well: Overview f DHS 34, including it s services and requirements Crisis Stabilizatin Prgramming Plicy and Prcedures Jb respnsibilities fr staff in the prgram Applicable parts f 48, 51, 55 and related rules The prvisins f s and DHS 92 regarding cnfidentiality f treatment recrds The prvisins f s and DHS 94 regarding patient s rights Basic mental health and psychpharmaclgy cncepts applicable t crisis situatins Techniques and prcedures fr assessing and respnding t the emergency mental health services needs f persns wh are suicidal, including suicide assessment, suicide management, and preventin Techniques fr assessing and respnding t emergency mental health service needs f persns wh appear have prblems related t the abuse f alchl r ther drugs. Techniques and prcedures fr prviding nn-vilent crisis management fr clients, including verbal deescalatin, methds fr btaining backup, and acceptable methds f self-prtectin and prtectin f the client and thers in an emergency situatin. Each crisis stabilizatin client will als be assigned a case manager wh will cnsult the medical, psychiatric, dietary, and scial service prviders n an as needed basis fr each client s individual needs. A client file will be maintained fr every crisis stabilizatin client. In the file, a crisis stabilizatin care episde lg and daily dcumentatin will be maintained with infrmatin f intake, discharge, time released, and wh the client was released t and the signature f staff wh released the child. The Assistant Directr f the prgram will be respnsible fr the versight f the Crisis Stabilizatin Services prgram. 5

6 Onging Stabilizatin Services Each day the child receiving stabilizatin services will be evaluated based n crisis stabilizatin criteria t determine his/her nging need fr services. On the first business day fllwing the initiatin f crisis stabilizatin services and daily thereafter, the stabilizatin prvider will cmmunicate with the cunty t examine the child s current status and the nging need fr stabilizatin services. This cntact will be dcumented in the client file. Discharge Fr Crisis Stabilizatin Services, the discharge plan will be crdinated in cllabratin with the cunty wrker and based upn the status f the child. A crisis assessment may be used t make the determinatin t discharge. The cunty will be respnsible fr the child s transitin back t the cmmunity within the 5-day timeline. If the child is nt able t be discharged within the 5-day limits, then the cunty wrker will determine the type f placement and the legal authrity f the placement that will be initiated. The cunty case manager will establish a time and persn t pick up the child at the end f the crisis stabilizatin services. Stabilizatin staff will nly release a child t the identified party. The Stabilizatin Prvider case manager will cmplete a Crisis Stabilizatin Discharge Summary fr each episde f care. This summary shall include infrmatin abut hw the child did while in the prgram and any significant incidents, as well as the name f the individual the child was released t. This dcument will als indicate that all belngings that were checked in at intake are leaving with the child, as well as all medicatins and any medical equipment. Prgram Evaluatin At discharge the parent/caregiver as well as the client will be prvided a survey t evaluate the crisis stabilizatin services. 6