Iowa Admin. Code r. 441-25.4 - Access standards
Regions shall meet the following access standards:
(1) A sufficient provider network which shall
include:
a. A community mental health center
or federally qualified health center that provides psychiatric and outpatient
mental health services to individuals in the region .
b. A hospital with an inpatient psychiatric
unit or state mental health institute located in or within reasonably close
proximity that has the capacity to provide inpatient services.
(2) Crisis services shall be
available 24 hours per day, 7 days per week, 365 days per year for individuals
experiencing mental health and disability-related emergencies. A region may
make arrangements with one or more other regions to meet the required access
standards.
a.
Basic crisis
response.
(1) Twenty-four-hour
crisis response . An individual shall have immediate access to crisis response
services by means of telephone, electronic, or face-to-face
communication.
(2) Crisis
evaluation . An individual shall have immediate access to a crisis screening and
will have a crisis assessment by a licensed mental health professional within
24 hours of referral.
b.
Crisis stabilization community-based services . An individual
who has been determined to need CSCBS shall receive face-to-face contact from
the CSCBS provider within 120 minutes from the time of referral.
c.
Crisis stabilization residential
services . CSRS shall be located within 120 miles from the residence of
the individual or be available within 120 minutes from the time of the
determination that the individual needs CSRS .
d.
Mobile response . An
individual in need of mobile response services shall have face-to-face contact
with mobile crisis staff within 60 minutes of dispatch.
e.
Twenty-three-hour observation and
holding . Twenty-three-hour observation and holding shall be located
within 120 miles from the residence of the individual or be available within
120 minutes from the time of the determination that the individual needs
23-hour observation and holding.
(3) The region shall provide the following
treatment services:
a.
Outpatient.
(1) Emergency
services : During an emergency, outpatient services shall be initiated to an
individual within 15 minutes of telephone contact.
(2) Urgent : Outpatient services shall be
provided to an individual within 1 hour of presentation or 24 hours of
telephone contact.
(3) Routine
care : Outpatient services shall be provided to an individual within four weeks
of request for appointment.
(4)
Distance: Outpatient services shall be offered within 30 miles for an
individual residing in an urban community and 45 miles for an individual
residing in a rural community .
b.
Inpatient.
(1) An individual in need of emergency
inpatient services shall receive treatment within 24 hours.
(2) Inpatient services shall be available
within reasonably close proximity to the region .
c.
Assessment and
evaluation . An individual who has received inpatient services shall be
assessed and evaluated within four weeks.
(4) Subacute facility-based mental health
services. An adult shall receive subacute facility-based mental health services
within 24 hours of referral. The service shall be located within 120 miles of
the residence of the individual .
(5) Support for community living for adults.
The first appointment shall occur within four weeks of the individual 's request
of support for community living services, including a home health aide, home
and vehicle modifications, respite , and supportive community living.
(6) Support for employment for adults. The
initial referral shall take place within 60 days of the individual 's request of
support for employment services, including day habilitation , job development ,
supported employment , and prevocational services .
(7) Recovery services for adults. An
individual receiving recovery services, including family support and peer
support, shall not have to travel more than 30 miles if residing in an urban
area or 45 miles if residing in a rural area to receive services.
(8) Service coordination.
a. An adult receiving service coordination
shall not have to travel more than 30 miles if residing in an urban area or 45
miles if residing in a rural area to receive services.
b. An adult shall receive service
coordination within ten days of the initial request for such service or being
discharged from an inpatient facility.
(9) The region shall make the following
intensive mental health services available for adults. A region may make
arrangements with one or more other regions to meet the required access
standards.
a.
Assertive community
treatment .
(1) A minimum of 22 ACT
teams shall be operational statewide.
(2) A sufficient number of ACT teams shall be
available to serve the number of individuals in the region who are eligible for
ACT services. As a guideline for planning purposes, the ACT -eligible population
is estimated to be about 0.06 percent of the adult population of the region .
The region may identify multiple geographic areas within the region for ACT
team coverage. Regions may work with one or more other regions to identify
geographic areas for ACT team coverage.
b.
Access centers.
(1) A minimum of six access centers shall be
operational statewide.
(2) An
access center shall be located within 120 miles of the residence of the
individual or be available within 120 minutes from the time of the
determination that the individual needs access center services.
c.
Intensive residential
services .
(1) A minimum of 120
intensive residential service beds shall be available statewide.
(2) An individual receiving intensive
residential services shall have the service available within two hours of the
individual 's residence.
(3) An
individual shall be admitted to intensive residential services within four
weeks from referral.
(10) The following limitations apply to home
and vehicle modification for an individual receiving mental health and
disability services :
a. A lifetime limit equal
to that established for the home- and community -based services waiver for
individuals with intellectual disabilities in the medical assistance
program .
b. A provider
reimbursement payment will be no lower than that provided through the home- and
community -based services waiver for individuals with intellectual disabilities
in the medical assistance program .
(11) The region shall make the following
efforts and activities related to children 's behavioral health available to the
residents of the region :
a.
Prevention . Prevention activities shall be carried out at
least four times a year.
b.
Education services . Education activities shall be carried out
at least four times a year.
(12) The region shall ensure that the
following behavioral health services are available to children in the region :
a.
Early identification . A
child shall receive early identification services within four weeks of the time
the request for such services is made.
b.
Early intervention . A
child shall receive early intervention services within four weeks of the time
the request for such services is made.
Notes
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