Alabama Administrative Code › Title 580 - ALABAMA DEPARTMENT OF MENTAL HEALTH › Chapter 580-2-9 - PROGRAM OPERATION › Section 580-2-9-.25 - Therapeutic Individualized Rehabilitation Services (TIRS)

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The program description is approved by
			 the board as specified in
			 580-2-9-.08(10)(b) and is consistent with the provisions of this section. The program description
			 shall include all of the following components:
(a) A description of the nature and scope of
			 the program that includes at a minimum the provision of services as specified
			 in this section and as indicated by individual consumer need.
(b) A description of the geographic service
			 area for the program.
(c) Admission
			 criteria that include at least the following:
1. Presence of Serious Emotional
			 Disturbance.
2. Age range from 5-18
			 years.
3. IQ of 70 or
			 above.
4. Must have been screened
			 and assessed for TIRS.
5. Must be
			 receiving active case management in addition to TIRS.
6. Clearly documented need to sustain and
			 maintain the child's placement in the home and community and prevent out of
			 home placement for the consumer.
7.
			 Admission is approved by a Licensed Independent Practitioner as specified in
			 580-2-9-.06(9)(g)6.
(d)
			 Discharge/transfer criteria and procedures shall be considered for discharge
			 from the program under any one of the following criteria:
1. The TIRS service time limit has been
			 reached (not to exceed 7 days per event).
2. The treatment goals have been met to the
			 extent that TIRS services are no longer needed.
3. The TIRS is unable to meet obvious,
			 suspected or expressed needs of the consumer and/or their family.
4. Transfer or referral to a different
			 program outside of TIRS will occur when it is determined that the transfer will
			 better meet the needs of the consumer and their family. Transfer shall be
			 considered under the following conditions.
(1)
			 The child or adolescent and family are in need of more intensive services that
			 the TIRS can provide.
(ii) The consumer is
			 determined to be in need of less intensive services than those provided by
			 TIRS.
(iii) The consumer and family
			 become eligible for a similar service elsewhere and prefer it.
(2) The following services must be
			 delivered within the program:
(a) A clinical
			 assessment that demonstrates the need for this level of care.
(b) The needs determination must be based
			 upon the approved DMH assessment tools.
(c) The consumer must be currently involved
			 with community mental health services and receiving case management services at
			 a minimum.
(d) The TIRS provider
			 may provide age appropriate family support and education, parent training,
			 basic living skills, socialization opportunities, mentoring services, and
			 advocacy as needed.
(e) TIRS shall
			 be documented as a needed service on the Treatment Plan.
(3) The individual and the home have to be
			 authorized to do so by the Alabama Department of Human Resources.
(4) Consumers who are deaf, hard of hearing,
			 or limited English proficient shall have effective communication access to
			 these services provided by:
(a) Staff fluent
			 in the consumer's preferred language, or
(b) A qualified interpreter or staff working
			 with consumers who are deaf shall have at least an Intermediate Plus level on
			 the Sign Language Proficiency Interview.
(5) TIRS are supervised by a staff member who
			 has a master's degree and 2 years of post-master's clinical experience. The
			 record shall document a minimum of one hour of face-to-face staffing
			 consultation with the supervisor weekly as documented in the consumer record
			 and shall include any recommendations made.
(6) TIRS shall reflect the following
			 characteristics and philosophy:
(a) TIRS is an
			 hourly or daily care for children or adolescents which is time-limited (not to
			 exceed 7 days per event).
(b) TIRS
			 are intended to sustain the child and maintain the child's placement in the
			 home and community.
(c) TIRS can
			 include, but is not limited to, social skills, leadership skills, mentoring
			 services, behavioral skills, and socialization opportunities.
(d) TIRS shall provide a community based
			 mental health service that will increase the consumer's ability to build and
			 establish adaptive social and emotional relationships.
(e) TIRS shall expand the consumer's
			 continuum of care by providing services to families and child-serving systems
			 to maintain children and adolescents in their local communities.
(f) TIRS shall provide an individualized
			 mentoring activity which will increase the social, emotional, and psychological
			 well-being of the consumer thereby reducing caregiver stress relate to the
			 day-to-day responsibilities of caring for a consumer with severe emotional
			 disturbance