36-550.05. Community mental health residential treatment services and facilities; prevention services

A. A residential or day treatment facility shall be designed to provide a homelike environment without sacrificing safety or care. Facilities shall be relatively small, with preferably fifteen or fewer beds.

B. Individual programs of a community residential treatment system shall include the following:

1. A short-term crisis residential treatment program. This program is an alternative to hospitalization for persons in an acute episode or situational crisis requiring temporary removal from the home from one to fourteen days. The program shall provide admission capability twenty-four hours a day, seven days a week in the least restrictive setting possible to reduce the crisis and stabilize the client. Services shall include direct work with the client's family, linkage with prevocational and vocational programs, assistance in applying for income, medical and other benefits and treatment referral.

2. A residential treatment program. This program shall provide a full-day treatment program for persons who may require intensive support for a maximum of two years. The program shall provide rehabilitation for chronic clients who need long-term support to develop independence and for clients who live marginally in the community with little or no support and periodically need rehospitalization. Services shall include intensive diagnostic evaluation, a full-day treatment program with prevocational, vocational and special education services, outreach to social services and counseling to assist the client in developing skills to move toward a less structured setting.

3. A secure behavioral health residential facility program. This program shall provide secure twenty-four-hour on-site supportive treatment and supervision by staff with behavioral health training only to persons who have been determined to be seriously mentally ill and chronically resistant to treatment pursuant to a court order issued pursuant to section 36-550.09.

4. A semisupervised, structured group living program. This program is a cooperative arrangement in which three to five persons live together in apartments or houses as a transition to independent living. The program shall provide an increase in the level of the client's responsibility for the functioning of the household and an increase in the client's involvement in daytime activities outside the house or apartment that are relevant to achieving personal goals and greater self-sufficiency. Services provided by the program shall include counseling and client self-assessment, the development of support systems in the community, a day program to encourage participation in the larger community, activities to encourage socialization and use of general community resources, rent subsidy and direct linkages to staff support in emergencies.

5. A socialization or day care/partial care program. This program shall provide regular daytime, evening and weekend activities for persons who require long-term structured support but who do not receive such services in their residential setting. The program shall provide support for persons who only need regular socialization opportunities and referral to social services or treatment services. The program shall provide opportunities to develop skills to achieve more independent functioning and means to reduce social isolation. Services shall include outings, recreational activities, cultural events and contact with community resources, such as prevocational counseling and life skills training.

C. Individual and family support prevention services shall provide assistance to the seriously mentally ill residing in their own home. Such prevention services shall include transportation, recreation, socialization, counseling, respite, companion services and in-home training.

D. Each individual program shall use appropriate multidisciplinary staff to meet the diagnostic and treatment needs of the seriously mentally ill and shall encourage use of paraprofessionals.

E. Each program shall have an evaluation method to assess the effectiveness of the programs and shall include the following criteria:

1. Prevalence and incidence of the target behavioral problem.

2. Cost effectiveness.

3. Potential for implementing the program using available monies and resources through cost-sharing.

4. Measurability of the benefits.

5. Effectiveness of intervention strategy.

6. Availability of resources and personnel.

F. Each community residential treatment system shall be designed to provide:

1. Coordination between each program and other treatment systems in the community.

2. A case management system to enhance cooperation of elements within the system and provide each client with appropriate services.

3. Client movement to the most appropriate and least restrictive service.

4. Direct referral of clients for specific programs that does not require the client to pass through the entire system to reach the most appropriate service.