Ala. Admin. Code r. 580-3-23-.06 - Definitions Of Types Of Certifications/Certificates

(1) Agency-specific.

(a) Community Mental Health Center (CMHC) - The entity providing mental health services in a coordinated manner that assures access to inpatient and residential care and to community supports for adults with serious mental illness and children and adolescents with severe emotional disturbances. CMHC's will be certified by DMH/MR as defined in the Alabama Administrative Code §580-2-13.01. The entity must provide the following services directly through its employees:

1. Emergency services.

2. Outpatient services.

3. Consultation and education services.

4. Partial hospitalization/intensive day treatment/rehabilitative day services in order to be certified as a CMHC. The entity must also provide residential services either directly or through agreement with another certified provider.

(b) Mental Health, Mental Retardation, or Substance Abuse Services Provider- An entity can be certified as a Mental Health Services Provider if it elects to provide one or more of the services required for Community Mental Health Center certification. The Mental Health, Mental Retardation, or Substance Abuse Services Provider may seek certification for any (but not all) of the following services:

1. Emergency services.

2. Outpatient services.

3. Consultation and education.

4. Substance abuse prevention activities

5. Partial hospitalization/intensive day treatment/rehabilitative day services/habilitation, or;

6. Residential services.

(c) 310 Boards Certification. - Code of Ala. 1967, Act Number 310, as codified in Code of Ala. 1975, Sections 22-51-1 through 14, provides for the formation of public corporations to contract with the DMH/MR in constructing facilities and operating programs for mental health services. Such entities are commonly referred to, and are referred to herein, as "310 Boards." 310 Boards will be certified by the DMH/MR as defined in the Alabama Administrative Code, Section 580-1-2-.02 and Section 580-1-2-.06.

(2) Location-specific.

(a) Community Residential Facility - A community-based living facility providing services to individuals with mental retardation, mental illness, or substance abuse in accordance with their assessed/identified needs.

1. Mental Illness Residential - A residential setting providing congregate living and dining to consumers. Residential services offered vary by type of program but all residential services must provide assistance with applying for benefits, social and communication skills, medication management, basic living skills, vocational skills, community orientation, recreational activities, transportation, education, and family support. Specific types of residential programs are defined in the Alabama Administrative Code, Section 580-2-13.

2. Mental Retardation Residential - A community-based living facility providing services to individuals with mental retardation in accordance with their assessed/identified needs, and the client's/guardian's choice of services and supports, and may address health, social, community living, personal, behavioral, basic living, work, and leisure skills, and other services/supports as needed and/or as desired by the individual to gain as much independence and self-direction as possible.

3. Substance Abuse Residential.

(i) Residential Detoxification - An acute care residential service that provides medical intervention intended to rid the client of the presence of alcohol or drugs in his/her system, to promote recovery from the toxic effects of the drugs or alcohol, and to restore psychological, physiological, and behavioral function. The service is intended for clients who are suffering from severe or prolonged alcohol or drug intoxication, have symptoms of withdrawal, and who require the control afforded by a treatment service providing twenty-four (24) hour monitoring by medical staff.

(ii) Crisis Residential Adult - A highly structured, short-term, intensive chemical dependency treatment services and intensive therapeutic activities, conducted in a twenty-four (24) hour supervised living arrangement operated by the facility staffed with awake employees around the clock, which is designed to initiate and promote the client's chemical free lifestyle.

(iii) Crisis Residential Adolescent - A highly structured, short-term, intensive chemical dependency treatment service, and intensive therapeutic activities, conducted in a twenty- four (24) hour supervised living arrangement operated by the facility using awake staff, around the clock, which is designed to initiate and promote the client's chemical free lifestyle. An adolescent is a minor child, age twelve (12) through eighteen (18) years, whose disabilities of minority have not been removed by judicial decree or by marriage. Programs specifically for adolescents must be designed to meet the special needs of adolescents, including academics.

(iv) Residential Rehabilitation - A residential service that provides chemical dependency supportive services and therapeutic activities conducted in a residential setting designed to provide the environment conducive to recovery and to promote reintegration into the mainstream of society.

(v) Residential Treatment for Pregnant and Postpartum Women - A residential service for pregnant women and their children that provides around the clock awake staff, continuously available onsite emergency medical assistance, a structured, and supervised peer group living arrangement emphasizing abstinence from alcohol/drugs, support group meetings, social, and vocational rehabilitation. It is a twenty-four (24) hour a day, seven (7) day per week, full time living arrangement, which offers childcare, linkages with education opportunities, job placement, and referral.

4. The following Community Residential Facilities occupied by four (4) or more consumers shall be classified as "new or existing Residential Board and Care Occupancies" (NFPA).

(i) Therapeutic group home.

(ii) Group foster home.

(iii) Partial hospitalization facility.

(iv) Residential substance abuse rehabilitation facility.

(v) Crisis residential substance abuse facility.

5. The following Community Residential Facilities occupied by three (3) or less consumers shall be classified new or existing one and two (2) family dwellings (NFPA).

(i) Foster Care Home (MI).

(ii) Semi-Independent Living Facility (MR).

(1) The following Community Residential Facilities occupied by three (3) or less, shall be classified new or existing apartments.

(i) Semi-independent Living Apartment (MI-MR).

(ii) Independent Living Apartment (MI-MR).

(b) Day services.

1. Mental Illness Day Treatment.

(i) Partial Hospitalization Program - An intensive, structured, active, clinical treatment program with the goal of acute symptom remission, hospital avoidance, and/or reduction of inpatient length of stay.

(ii) Adult Intensive Day Treatment - An identifiable and distinct program that provides highly structured services designed to bridge acute treatment and increased level of functioning and enhance community integration.

(iii) Rehabilitative Day Program - An identifiable and distinct program that provides long-term recovery, achievement of personal life goals, recovery of self-worth, illness management, and help to consumers to allow them to become productive participants in family and community life.

(iv) Child and Adolescent Day Treatment - A combination of goal oriented treatment services provided according to a multiple hour schedule over a week's time for clients under the age of 18. Key service functions will include initial screening, development of an individualized plan; individual group, and family psychiatric interventions; education for client's parents/guardians regarding emotional/cognitive development and needs, personal care skills, and services to enhance, family, social, community, and leisure skills.

2. Mental Retardation Day Habilitation Services - Services that focus on providing assistance with acquisition, retention, or improvement in self-help, socialization, work, and adaptive skills, occurring in a non-residential setting, separate from the home or facility in which the individual normally resides. Day habilitation services are based on identified needs and desires of the client, and may also serve to reinforce skills or lessons taught at school, in therapy, at home, or other setting.

(c) Outpatient/Case Management/Other Hourly Services.

1. Mental Illness.

(i) General Outpatient - A program that includes a variety of treatment modalities and techniques and admission criteria inclusive of all ages, persons with serious mental illness/severe emotional disturbance, and persons discharged from inpatient psychiatric treatment. Services are planned and designed to assess and meet individual needs.

(ii) Emergency Services - The program must provide a twenty-four (24)-hour per seven (7) day week capability to respond to an emergency need for mental health services for enrolled consumers. Such capability shall include a telephone response by a clinician or a trained volunteer, face-to-face response by a clinician, and adequate provision for handling special and difficult cases.

(iii) Case Management - A client, focused strategy for engaging seriously mentally ill (SMI) adults and severely emotionally disturbed (SED) children/adolescents in necessary community support systems and services in order to improve their chances for recovery and successful community living. Key services include client specific assessment of need, development of a client coordinated written plan, assisting client through crisis situation, and/or arranging for the provision of assistance, services and ongoing reevaluation of needs and progress towards goals.

2. Mental Retardation - Case Management services which will assist individuals in gaining access to needed services and supports, to include funding for services, as well as needed medical, social, educational and other services and supports, to include crisis and advocacy services; ongoing monitoring of the provision of services included in the individual's plan of care; assessment/re-assessment of level of care and review of plans of care. Other hourly services are those non-medical care, supervision, and socialization that would prevent the need for institutionalization.

3. Substance Abuse.

(i) Opioid Treatment-Opioid treatment is the dispensing of an opioid agonist treatment medication, along with a comprehensive range of medical and rehabilitative services to an individual to alleviate the adverse medical, psychological or physical effects incident to opiate addiction. Admission to maintenance treatment will be made by qualified personnel using accepted medical criteria such as the Diagnostic and Statistical Manual for Mental Disorders (DMS-IV), to determine that the person is currently addicted to an opioid drug, and that the person became addicted at least one year before admission to treatment. This service may also include short-term detoxification (less than thirty (30) days) or long-term detoxification (more than thirty (30) days, less than one hundred eighty (180) days).

(ii) Intensive Adult/Adolescent - Chemical dependency treatment services and intensive therapeutic activities provided to adult/adolescents which are designed to initiate and promote a client's chemical free lifestyle in a non-residential setting. At a minimum this service has to be offered 2.5 hours a day, three days a week.

(iii) Intensive Specialized Women's Programs - Chemical dependency treatment services and intensive therapeutic activities provided to pregnant women and women with dependent children which are designed to initiate and promote a client's chemical free lifestyle. The programs must provide a standard psychosocial assessment, gender-specific substance abuse education, gender specific substance abuse therapy; group, family, and individual counseling; supportive counseling/education and detoxification if needed.

(iv) Prevention Program - Strategies developed to limit substance experimentation/use from beginning, or the identification and education in the earliest stages of alcohol, tobacco, or other drug use/abuse to preclude the onset of detrimental effect.

(v) Case Management - A service designed to assist individuals in accessing a broader array of services: physical and mental health, educational, vocational, financial, and legal, etc. Case Management includes needs assessment, case planning, crisis intervention, transportation, linkage to other resources, and advocacy.

(vi) Detoxification - A safe and effective medical management process provided in a non-residential setting for the purpose of withdrawing an individual from an addictive substance; the process is designed to result in normal physiological functioning.

(vii) Individual Counseling - A one-on-one interaction between an individual client and a counselor or therapist designed to assist in identifying and addressing those issues and problems specific to that person which prevent the initiation and maintenance of a lifestyle free of chemicals of abuse.

(viii) In-Home Intervention (pregnant women and women with dependent children)-Time limited, home based services provided by a treatment team (two-person team, one master's level substance abuse professional and one person with a bachelor's level degree) to alleviate an immediate crisis situation, stabilize the family unit, and prevent out-of-home placement of the client.

(ix) Ancillary Services (specialized women's programs only)-These services include parenting, case management, childcare, and transportation (if needed).

(x) Family Counseling-A structured interaction of the client and/or his/her family member(s) with a counselor or therapist designed to assist the family in identifying and addressing those issues and problems that prevent the initiation and maintenance of a lifestyle free of chemicals.

(xi) Diagnostic Testing - Administration of standardized objective and/or projective tests of an intellectual, personality, or related nature in a face-to-face interaction between the client and staff member and interpretation of the test results.

(xii) HIV counseling (individual, group, family, case management) - A structured interaction between substance abuse treatment clients and a qualified SA counselor or HIV specially trained therapist designed to assist clients in preparing for HIV testing, dealing with test results, and/or modifying risky behavior designed to reduce the transmission of HIV.

4. Outpatient/Case Management-The following outpatient services facilities shall be classified as "New or existing Business occupancies" (NFPA).

(i) Mental Health Services Provider.

(ii) Community Mental Health Center.

(iii) Community Mental Health Center Satellite Facilities.

5. The following Day Services Facilities shall be classified as "New or existing Educational occupancies" (NFPA).

(i) Intensive Day Treatment (MI).

(ii) Rehabilitation Day Treatment (MI).

(iii) Child and Adolescent Day Treatment (MI).

(iv) Day Habilitation Services (MR).

(v) Day Training Facilities (MR).

(vi) Work Activity Center (MR).

(vii) Outpatient Services (SA).

(viii) Intensive Outpatient Services (SA).

(ix) Specialized Women's (SA).

(x) Methadone Clinic/Opiate Replacement (SA).

Author: DMH/MR Office of Certification

Authority: Code of Ala. 1975, § 22-50-11.

Notes

Ala. Admin. Code r. 580-3-23-.06

New Rule: Filed October 1, 2001; effective November 5, 2001. Amended: Filed August 13, 2002; effective September 17, 2002.