N.H. Admin. Code § Cor 302.03 - Diagnosis, Counseling, and Therapy

(a) There shall be an outpatient behavioral health unit which shall provide for the person under departmental control's behavioral health needs as determined by completion of an initial behavioral health interview and a biopsychosocial assessment which results in a mental health diagnosis. Referrals for such assessments may be via self-referral made by inmates themselves or by any departmental staff member. These referrals shall be triaged accordingly, and for those cases requiring on-going behavioral health treatment, a treatment plan shall be developed and filed in the person under departmental control's medical record.

(b) The behavioral health unit shall be sufficiently staffed to include at a minimum:

(1) A full-time New Hampshire licensed administrative clinician who shall:

a. Oversee and supervise the testing operations and determine what types of behavioral health interventions are needed;

b. Conduct staff training, triage referrals to the behavioral health unit, and assist behavioral health staff with individual cases;

c. Provide individual and group counseling and supervise the provision of such counseling by mental behavioral health clinicians; and

d. Review the behavioral health needs of the persons under departmental control and implement new treatment modalities as indicated;

(2) New Hampshire licensed psychiatric providers who shall provide for the psychiatric needs of the persons under departmental control and the secure psychiatric unit including prescription of medications, coordination of care between disciplines, and consultation with administration with regard to behavioral health policy development; and

(3) A sufficient number of full-time clinical staff who, at a minimum, shall be qualified under the state personnel system to include, without being limited to, social workers or clinical mental health counselors.

(c) Newly arrived persons under departmental control shall be processed in a reception cycle during which the person under departmental control shall be interviewed and assessed under the supervision of the administrative clinician to determine, where possible, whether the person under departmental control is suffering from mental illness requiring further interventions from the behavioral health delivery system.

(d) Reception cycle operations shall include any or all of the following:

(1) Administration of screening and assessment tools that are necessary to adequately identify behavioral health needs;

(2) An initial behavioral health interview which shall include but not be limited to:

a. Obtaining a behavioral health history;

b. Recommendations for further screenings, assessments and/or tests;

c. Advising each person under departmental control as to the their behavioral health needs, sexual offender treatment needs, and how to access services; and

d. Referrals to medical, psychological, psychiatry, educational, or others staff for counseling, and treatment, and other interventions.

(e) The department shall initiate procedures to transfer a person under departmental control when in the opinion of the psychiatrist, physician, or psychiatric nurse practitioner the inmate person is suffering from a psychological or psychiatric impairment or intellectual disability which could be treated or managed better in the secure psychiatric unit or other mental health or medical facility due to a threat of harm to themselves or others per RSA 623.

(f) The out-patient behavioral health unit shall provide at a minimum the following services:

(1) Documentation and implementation of a treatment plan;

(2) Psychiatric services;

(3) Medication management;

(4) Individual counseling pursuant to RSA 329-B;

(5) Group therapy sessions as appropriate; and

(6) Such other specialized treatment for individuals or groups of persons under departmental control as needed.

(g) Behavioral health services shall be available to all persons under departmental control regardless of their custody status.

(1) Individuals who are transferred to the restricted housing settings such as the special housing unit (SHU) shall be screened prior to being placed in a cell. Behavioral health shall conduct a suicide risk assessment and suitability review of the individual's placement. If behavioral health is not on-site, nursing staff shall conduct the assessment within health services. All staff shall complete appropriate clinical documentation recording the assessment and outcome of the assessment in the individual's health record. If the individual presents at risk as a result of the assessment, alternative housing arrangements shall be made to secure the individual for their safety;

(2) Individuals who are prescribed psychotropic medications or are diagnosed with a severe and persistent mental illness (SPMI) that are housed in the SHU shall have clinical appointments scheduled at least every 14 business days that will include at a minimum the following:

a. Mental status examination as follows:

1. Appearance;

2. Interaction;

3. Speech;

4. Mood/Affect;

5. Thought Process;

6. Thought Content;

7. Suicidality; and

8. Violence;

b. A review of their medications and any reported side-effects for triaging to psychiatric providers;

c. A subjective statement of each individual's current emotional status;

d. An assessment of diagnosis/es with reflection of psychiatry's perspective, if available in the health record;

e. A treatment plan, or an updated existing treatment plan, will be updated which may include referral to a case manager, assignment to group therapy, triage to medical staff, or other individual specific goals based on the clinical appointment; and

f. A monthly report of these clinical appointments to track compliance to the 14-day standard and treatment plan development which shall be reviewed by the Director of Medical and Forensic Services for compliance to the standards;

(3) The department will provide a psycho-social skill development program in restricted housing settings at all facilities. Such programs will be provided in consultation with the bureau of behavioral health. These shall operate in quarterly cycles with at a minimum of 4 offerings a year for individuals referred in these settings by the behavioral health staff;

(4) The correctional staff assigned to restricted housing settings shall be provided with specific training at a minimum of quarterly on topics related to the treatment and supervision of individuals with behavioral health issues; and

(5) The correctional staff assigned to restricted housing settings will conduct at a minimum 30-minute rounds on individuals housed in theses settings on psychotropic medications or diagnosed with a severe and persistent mental illness.

(h) There shall be a therapeutic community in the form of a residential treatment unit (RTU) as follows for those persons under departmental control who because of significant functional impairment due to their documented mental illness are unable to successfully live in the general population:

(1) The RTU shall be sufficiently staffed to include at a minimum:

a. A full time administrator who shall:

1. Oversee the day to day operations of RTU to ensure proper procedures are followed regarding admission, treatment, and discharge of patients and persons under departmental control;

2. Manage the process of evaluating and triaging inmates those referred for RTU services; and

3. Supervise the collection of quality improvement data and participate in the development of quality improvement benchmarks;

b. Sufficient clinical staff to meet the treatment needs of those receiving treatment in the RTU in the areas of recreational therapy, psychological services, special education, mental health therapy, medical care, safety, and but not limited to psychiatric interventions; and

(2) Persons under departmental control admitted to the RTU shall receive a complete evaluation of their psychiatric needs including at a minimum:

a. A complete psychiatric evaluation;

b. A comprehensive clinical assessment; and

c. An assessment of skills required to successfully navigate in their housing unit; and

(3) Above mentioned assessments shall result in the development of a master treatment plan that specifically addresses the individual's clinical needs.

(i) There shall be a sexual offender treatment services unit which provides for the treatment needs of individuals who are incarcerated for sexually-related offenses, and which meets the following requirements:

(1) The sexual offender treatment services unit shall be sufficiently staffed to provide services as follows:

a. A full time administrator who shall:

1. Oversee and supervise the assessment and treatment of services for individuals identified as in need of these services;

2. Review the sexual offender treatment needs of the individuals and implement treatment modalities as indicated;

3. Provide individual and group therapy and supervise the provision of such services by other sexual offender treatment therapists; and

4. Conduct staff training and supervision; and

b. A sufficient number of full-time clinical staff who at a minimum shall be qualified under the state personnel system; and

(2) Referrals to sexual offender treatment services shall be made through the initial classification process and on-going as needs are identified by departmental staff. Assessments shall be based on risk and needs assessment and triaged into appropriate treatment services accordingly by trained sexual offender treatment staff;

(3) Individuals convicted of sexual offenses who are willing to participate in sexual offender treatment services shall be provided with an initial screening assessment in order to determine their treatment needs which shall include:

a. A complete comprehensive clinical assessment;

b. A risk and needs assessment;

c. A determination of required services will be provided to the inmate individual;

d. A review of any special accommodations necessary to participate in treatment (e.g. language barriers, intellectual disability or accessibility issues); and

e. A referral to any other services as indicated;

(4) Individuals shall be placed into the appropriate form of treatment services or on the waiting list for appropriate services; and

(5) The sexual offender treatment services unit shall at a minimum provide the following services:

a. Specific needs assessment to determine the specific treatment needs of each individual as it relates to his or her sexual offender treatment;

b. The development of an individualized treatment plan specific to sexual offender treatment;

c. Group and individual therapy sessions;

d. Discharge planning;

e. Coordination with other prison services and external services as indicated by the individual's specific sexual offender treatment needs; and

f. Treatment reviews of services to ensure public safety and risk mitigation through the establishment of an administrative review committee as follows:

1. The administrative review committee shall review the outcome of sexual offender treatment services. The administrative review committee shall provide oversight to ensure the department is meeting its mission in preventing further victimization from sexually-related crimes;

2. The purpose of the administrative review committee is to ensure that each individual participating in the department's sexual offender treatment service has satisfactorily completed their treatment goals as specified on their individualized treatment plan and outlined by the clinicians discharge summary proposal;

3. The clinician shall present the case, relating the individual's progress to his goals. The clinician shall also provide information on any disciplinary action, and/or behaviors that resulted in being removed from the program, if applicable. Included in the case presentation shall be a description of the individual's self-management plan for the community to include therapeutic, vocational, educational and housing activities established for transition;

4. The administrative review committee shall review each case and make recommendations for the case. If treatment is not deemed completed, the administrative review committee shall provide recommendations to enhance attainment of treatment goals to the clinician for implementation with the individual;

5. The administrative review committee shall meet on a regular basis;

6. The administrative review committee shall be comprised of administrators and/or senior level clinicians from the division of medical and forensic services as assigned by the director of medical and forensic services; and

7. Decisions made by the administrative review committee may be appealed through the department's grievance process.

Notes

N.H. Admin. Code § Cor 302.03

(See Revision Note at chapter heading for Cor 300) #7448, eff 2-6-01; ss by #9383, INTERIM, eff 2-3-09, EXPIRES: 8-3-09; ss by #9508, eff 7-8-09 (from Cor 302.04 )

Amended by Volume XXXVII Number 41, Filed October 12, 2017, Proposed by #12396, Effective 9/29/2017, Expires 3/28/2018. Amended by Volume XXXVIII Number 15, Filed April 12, 2018, Proposed by #12502, Effective 3/23/2018, Expires 3/23/2028.