Iowa Admin. Code r. 441-24.38 - Crisis stabilization community-based services (CSCBS)
The goal of
(1)
Eligibility. To be eligible, an individual must:
a. Be determined appropriate for the service
by mental health assessment ; and
b.
Be determined not to need inpatient acute hospital psychiatric
services.
(2) Staffing
requirements.
a. A designated director or
administrator is responsible for the management and operation of the
CSCBS .
b. At least one licensed
nurse practitioner, physician assistant, or psychiatrist is available for
consultation 24 hours a day, 365 days a year.
c. Mental health professionals with expertise
appropriate to the individual's needs provide services.
d. Contact between the individual and a
mental health professional occurs at least one time a day.
e. Additional services are provided by crisis
response staff at a minimum of one hour per day, including, but not limited to,
skill building, peer support or family support peer services. The goal of CSCBS
is to stabilize the individual within the community . CSCBS is designed for
voluntary services for individuals in need of a safe, secure location that is
less intensive and restrictive than an inpatient hospital.
f. Crisis response staff must be awake and
attentive 24 hours a day.
(3) Performance benchmark. The individual
using CSCBS is provided safe, secure and structured crisis stabilization
services in the least restrictive location meeting the needs of the individual.
The CSCBS can be for youth aged 18 and under or adults aged 18 and
older.
(4) Performance indicators .
a. The individual can provide consent for
treatment providers, family members and other natural supports to be contacted
within 24 hours of admission.
b.
Daily crisis stabilization services include, at minimum, daily contact with a
mental health professional and one hour of additional crisis stabilization
services from crisis response staff .
c. The numbers of days an individual receives
crisis stabilization services are documented. The documentation records
specific reasons for the delivery of services beyond five days.
d. Individual records are maintained to
document the following:
(1) Daily contact
with a mental health professional .
(2) Additional services provided including,
but not limited to, skill building, peer support or family support peer
services.
(3) Medication
record.
e. Individual
choice is verified including, but not limited to, treatment participation and
discharge plan options.
f.
Readmission data is tracked, including an analysis of data trends looking at
effectiveness, and appropriate corrective action taken. The information is
documented in the performance improvement system files.
(5) Crisis stabilization incident reporting.
a. Performance benchmark. An incident report
is filed when staff are notified an incident has occurred.
b. Performance indicators .
(1) The incident report documents:
1. The name of the individual involved in the
incident .
2. Date and time the
incident occurred.
3. A description
of the incident .
4. Names and
signatures of all staff present at the time of the incident .
5. The action the staff took to handle the
situation.
6. The resolution or
follow-up to the incident .
(2) A copy of the incident report is kept in
a centralized file and a copy given to the individual, the mental health and
disability services region, and the parent or guardian when appropriate .
(6) Service
requirements.
a. Stabilization plan . The
individual in crisis is involved collaboratively in all aspects of crisis
stabilization services including, but not limited to, admission, treatment
planning, intervention, and discharge. The involvement of family members and
others is encouraged.
Within 24 hours of an individual's admission to crisis
stabilization services, a written short-term
(1)
Criteria for discharge, including referrals and linkages to appropriate
services and coordination with other systems.
(2) Description of any physical disability
and any accommodations necessary to provide the same or equal services and
benefits as those afforded nondisabled individuals.
(3) Evidence of input by the individual,
including the individual's signature.
(4) Goal statement. Goals are consistent with
the individual's needs and projected duration of service delivery and include
objectives which build on strengths and are stated in terms allowing
measurement of progress.
(5) Rights
restrictions.
(6) Names of all
other persons participating in the development of the plan.
(7) Specification of treatment
responsibilities and methods.
b. Performance benchmark.
A
c.
Performance indicators .
(1) Individual
records include a written short-term stabilization plan developed with the
involvement and consent of the individual within 24 hours of admittance and
reviewed frequently to assess the need for continued placement in
CSCBS .
(2) Individual records
indicate a crisis stabilization plan is completed within the 24-hour time
frame.
(3) Reasons for crisis
stabilization plans not meeting the criteria are documented.
(4) A follow-up appointment with the
individual's preferred provider will be made, and crisis response staff will
follow up with the individual and document contact or attempt to contact on a
periodic basis until the appointment takes place.
(7) Treatment summary . Prior to
the individual's discharge from CSCBS , a treatment summary is completed. A copy
of the summary is provided to the individual and shared with the individual's
treatment team of providers, if applicable.
a. Contents. At a minimum, the treatment
summary includes:
(1) Course and progress of
the individual with regard to each identified problem.
(2) Documented note of a mental health
professional contact one time daily.
(3) Evolution of the mental status to inform
ongoing placement and support decisions.
(4) Final assessment , including general
observations and significant findings of the individual's condition initially
while services were being provided and at discharge.
(5) Recommendations and arrangements for
further service needs.
(6)
Signature of the mental health professional .
(7) Stabilization plan .
(8) Reasons for termination of
service.
(9) Treatment
interventions.
b.
Performance benchmark.
A
c. Performance
indicators .
(1) Records include a written
treatment summary developed with the involvement of the individual. A copy of
the summary is provided upon discharge.
(2) Incidents in which a treatment plan was
not completed within the length of stay and any corrective action necessary to
alleviate this issue are documented.
(8) Health and safety.
a. Performance benchmark. Emergency
preparedness policies and procedures include health and safety
measures.
b. Performance
indicators .
(1) Emergency preparedness plans
are designed to provide effective utilization of available resources for care
to continue during a disaster event including, but not limited to, cases of
severe weather or fire.
(2) Crisis
services comply with rule
441-24.39 (225C).
Notes
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No prior version found.