Alabama Administrative Code › Title 580 - ALABAMA DEPARTMENT OF MENTAL HEALTH › Chapter 580-2-20 - PROGRAM OPERATION › Section 580-2-20-.12 - MI Day Programs

Current through Register Vol. 42, No. 9, June 28, 2024
The agency shall have a program description for MI Day Treatment
				service/program. The program description shall include all requirements per
				580-2-20-.09(2) (a-e) General Clinical Practice and the program(s) criteria as
				follows:
(1)
Adult
			 Rehabilitation Day Program (RDP).
The program description is
			 consistent with the provisions of this section and defines Rehabilitative Day
			 Program (RDP) as an identifiable and distinct program that provides long-term
			 recovery services with the goals of improving functioning, facilitating recovery,
			 achieving personal life goals, regaining self-worth, optimizing illness management,
			 and helping recipients to become productive participants in family and community
			 life. The program description shall include all of the following components:
(a) A description of the target population of
			 serious mental illness (SMI).
(b) Age
			 range.
(c) Nature and scope of the
			 program, as indicated by individual recipient needs and preferences.
(d) Location of the geographic service area for
			 the program.
(e) Specifies that the
			 program is staffed by qualified individuals whose primary job function is specific
			 to Rehabilitative Day Program.
(f)
			 Admission criteria shall address inclusionary criteria as follows:
1. Presence of a psychiatric diagnosis.
2. Mild to moderate persistent, chronic, and/or
			 refractory symptoms and impairments in one (1) or more areas of living (e.g.
			 difficulty attaining & sustaining life goals and/or community
			 integration).
3. Does not meet admission
			 or continued stay criteria for more intensive levels of care such as PHP or AIDT but
			 requires the daily structure and services of a recovery oriented rehabilitative
			 milieu to improve or maintain level of functioning, achieve personal life goals, and
			 sustain a positive quality of life.
4.
			 RDP services are reasonably expected to improve the individual's functional level,
			 increase quality of life, and facilitate attainment of personal life
			 goals.
5. Be approved by a qualified
			 staff member.
(g)
			 Discharge/transfer criteria shall include the following:
1. Rehabilitative goals have been met and the
			 individual no longer needs this type of service.
2. Less intensive levels of care can reasonably be
			 expected to improve or maintain the individual's level of symptom remission,
			 condition, functional level, quality of life, attainment of life goals, and
			 recovery; or the degree of impairment, severity of symptoms, and/or level of
			 functioning necessitates admission to a more intensive level of care.
3. The individual primarily needs support,
			 activities, socialization, or custodial care that could be provided in other less
			 intensive settings (e.g. peer support group, drop in center, or senior citizen's
			 center).
4. The individual chooses not
			 to participate.
(h)
			 Exclusionary criteria must include the following:
1. The person's level of functioning requires a
			 more intensive level of care.
2. The
			 individual is not experiencing mild or moderate persistent, chronic symptoms,
			 impairments in one (1) or more areas of daily life, difficulty attaining and
			 sustaining life goals and/or problems with community integration.
(i) The RDP constitutes active
			 structured, rehabilitative interventions that specifically address the individual's
			 life goals, builds on personal strengths and assets, improves functioning, increases
			 skills, promotes a positive quality of life, and develops support networks. The RDP
			 should include an initial screening and an individualized treatment plan. Based on
			 the specific focus of the program and the needs and preferences of recipients, the
			 adult RDP shall provide the following:
1. Initial
			 screening to evaluate the appropriateness of the recipient's participation in the
			 program.
2. Development of an
			 individualized program plan.
3. As well
			 as at least one (1) more service from the following based on the needs and
			 preferences of recipient's participation in the program:
(i) Psychoeducational services
(ii) Basis Living Skills
(iii) Coping skills training closely related to
			 presenting problems (e.g., stress management, symptom management, assertiveness
			 training, and problem solving)
(iv)
			 Utilization of community resources.
(j) The program coordinator must have at a minimum
			 a bachelor's degree in a mental health related field and at least one (1) year of
			 direct service experience in a mental health setting or be a registered nurse with
			 at least one (1) year of mental health experience.
(k) The overall staff present to recipient ratio
			 cannot exceed one to twenty (1:20). If a program has a capacity of twenty (20) or
			 less, an additional staff person should be present during the hours of operation to
			 permit individualized treatment.
(l)
			 Records document that recipients admitted to the RDP meet the admission
			 criteria.
(m) Records document that the
			 recipients admitted to the RDP do not meet the exclusionary criteria.
(n) Rehabilitative Day Programs shall be scheduled
			 at least four (4) hours per day one (1) day per week.
(o) Recipients who are deaf or who have limited
			 English proficiency shall have effective communication access provided by staff
			 proficient in the recipients' preferred language, or by a qualified interpreter.
			 Proficient in American Sign Language is defined as having at least an Intermediate
			 Plus level in the Sign Language Proficiency Interview.
(p) Documentation that communication access has
			 been provided for recipients who are deaf or who have limited English
			 proficiency.
(q) The use of family
			 members to interpret is discouraged due to the possibility of conflicts of interest.
			 If family members are used to interpret, this shall be noted on the waiver. Family
			 members under the age of eighteen (18) cannot be used as interpreters.
(r) Programming will be modified to provide
			 effective participation for all recipients who are deaf.
(s) Recipients are scheduled to attend RDP at
			 least once a week based on individual goals, preferences, needs and
			 circumstances.
(t) The record documents
			 that the treatment plan for rehabilitative day services is evaluated at least every
			 three (3) months to assure that continued participation in RDP is clinically
			 indicated.