reglab/statecodes huggingface dataset:
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 22 - Autism Support Program › Rule 441-22.7 - Financial Management of the Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The department shall:
a. Not take new applications for the program
				that would cause expenditures of the program to exceed the budgeted
				amount.
b. Limit expenditure of
				program funds to services for those individuals determined to be eligible
				individuals and for related administrative costs.
c. Allocate available funds for eligible
				individuals' services in a manner that allows for funding for all eligible
				individuals' services authorized by the administrator without exceeding the
				department's funding limits.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.2 - Standards for Policy and Procedures

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Performance benchmark.
The organization has written policy direction for the organization and each
				service being accredited.
(2)
Performance indicators.
a.
				The organization has a policies and procedures manual with policy guidelines
				and administrative procedures for all organizational activities and services
				specific to its organization that addresses the standards in effect at the time
				of review.
b. The policies and
				procedures cover each benchmark and indicator in this chapter
c. The policies and procedures manual is made
				available to all staff.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.3 - Standards for Organizational Activities

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Performance improvement
				system.
a.
Performance
				benchmark.
The organization has a systematic, organizationwide,
				planned approach to designing, measuring, evaluating, and improving the level
				of its performance.
b.
Performance indicators.
The organization:
(1) Annually measures and assesses
				organizational activities and services accredited in this chapter.
(2) Gathers information from individuals
				using the services, from staff, and from family members.
(3) Implements an internal review of
				individual records for those services accredited under this chapter. For
				outpatient psychotherapy and counseling services, the organization:
1. Reviews the individual's involvement in
				and with treatment.
2. Ensures that
				treatment activities are documented and are relevant to the diagnosis or
				presenting problem.
(4)
				Reviews the organization's response to incidents reported under subrule 24.4(5)
				for necessity, appropriateness, effectiveness and prevention. This review
				includes analysis of incident data at least annually to identify any patterns
				of risk to the health and safety of consumers.
(5) Reviews the organization's response to
				any situation that poses a danger or threat to staff or to individuals using
				the services for necessity, appropriateness, effectiveness, and
				prevention.
(6) Identifies areas in
				need of improvement.
(7) Has a plan
				to address the areas in need of improvement. Where applicable, the organization
				establishes a plan to resolve the problem of patients missing
				appointments.
(8) Implements the
				plan and documents the results.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.4 - Standards for Services

Current through Register Vol. 47, No. 3, July 24, 2024
Providers for the services set forth in subrules 24.4(9)
				  through 24.4(13) shall meet the standards in subrules 24.4(1) through 24.4(8)
				  in addition to the standards for the specific service. Providers of outpatient
				  psychotherapy and counseling services shall also meet standards in subrules
				  24.4(1), 24.4(2), 24.4(4), 24.4(6), 24.4(7), and 24.4(8). Providers of
				  emergency services or evaluation services shall meet the benchmark for the
				  services they provide.
(1)
Social history.
a.
Performance benchmark.
The organization completes a social
				history for each individual served.
b.
Performance indicators.
(1) The organization collects and documents
				relevant historical information and organizes the information in one distinct
				document.
(2) The social history
				includes:
1. Relevant information regarding
				the onset of disability.
2. Family,
				physical, psychosocial, behavioral, cultural, environmental, and legal
				history.
3. Developmental history
				for children.
4. Any history of
				substance abuse, domestic violence, or physical, emotional, or sexual
				abuse.
(3) Staff review
				and update the social history at least annually.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.5 - Accreditation

Current through Register Vol. 47, No. 3, July 24, 2024
The division administrator shall make all decisions involving
				  issuance, denial, or revocation of accreditation. This accreditation shall
				  delineate all categories of service the organization is accredited to provide.
				  Although an organization may have more than one facility or service site, the
				  division administrator shall issue only one accreditation notice to the
				  organization, except as provided in paragraph
				  24.5(5)
"f."
(1)
Organizations eligible for accreditation.
The division
				administrator accredits the following organizations:
a. Case management providers.
b. Community mental health centers.
c. Supported community living
				providers.
d. Mental health service
				providers.
e. Crisis response
				providers.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.6 - Deemed Status (all services)

Current through Register Vol. 47, No. 3, July 24, 2024
The division shall grant deemed status to organizations
				  accredited by a recognized national, not-for-profit, accrediting body when the
				  division determines the accreditation is for similar services. The division may
				  also grant deemed status for supported community living services to
				  organizations that are certified under the Medicaid home- and community-based
				  services (HCBS) intellectual disability waiver.
(1)
National accrediting
				bodies.
a. The national accrediting
				bodies currently recognized as meeting division criteria for possible deeming
				are:
(1) The Joint Commission (TJC).
(2) The Commission on Accreditation of
				Rehabilitation Facilities (CARF).
(3) The Council on Quality and Leadership
				(The Council).
(4) The Council on
				Accreditation (COA).
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.7 - Complaint Process (all services)

Current through Register Vol. 47, No. 3, July 24, 2024
The division shall receive and record complaints by
				  individuals using the services, employees, any interested people, and the
				  public relating to or alleging violations of applicable requirements of the
				  Iowa Code or administrative rules.
(1)
Submittal of complaint.
The complaint may be submitted in
				person; or by mail to the Division of Mental Health and Disability Services,
				Community, Department of Human Services, Hoover State Office Building, Fifth
				Floor, 1305 East Walnut, Des Moines, Iowa 50319-0114; electronically through
				the department's website; by email to division staff; or by telephone.
a. The division shall assist individuals in
				making a complaint as needed or requested.
b. The information received should
				specifically state the basis of the complaint. The division shall keep the name
				of the complainant confidential to the extent allowed by law.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.8 - Appeal Procedure

Current through Register Vol. 47, No. 3, July 24, 2024
An appeal may be filed using the procedure identified in
				  441-Chapter 7. Notice of an appeal shall be sent to Appeals Section, Department
				  of Human Services, Hoover State Office Building, Fifth Floor, 1305 East Walnut,
				  Des Moines, Iowa 50319-0114, within 30 calendar days of the written decision
				  from the commission.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.9 - Exceptions to Policy

Current through Register Vol. 47, No. 3, July 24, 2024
Requests for exceptions to the policies in this chapter shall
				  follow the policies and procedures in the department's general rule on
				  exceptions to policy at 441-1. 8(17A,217).
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.21 - Standards for Crisis Response Services

Current through Register Vol. 47, No. 3, July 24, 2024
An organization may be accredited to provide any one or all
				  of the identified crisis response services. An organization seeking crisis
				  response service accreditation shall comply with the general standards within
				  this division and additional standards for each specific
				  service.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.22 - Standards for Policies and Procedures

Current through Register Vol. 47, No. 3, July 24, 2024
Policies and procedures manuals contain policy guidelines and
				  administrative procedures for all activities and services and address the
				  standards in rule 441- 24.2(225C).
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.23 - Standards for Organizational Activities

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The organization shall meet the standards
				in subrules 24.3(1) through 24.3(5).
(2) The organization shall describe the
				staffing structure that details how staff are utilized to provide the specific
				crisis stabilization services in rules
				441-24.32
				(225C) through
				441-24.39
				(225C).
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.24 - Standards for Crisis Response Staff

Current through Register Vol. 47, No. 3, July 24, 2024
All crisis response staff shall meet the qualifications
				  described in this rule. Additional staff requirements are described in each
				  service.
(1)
Performance
				benchmark.
Qualified crisis response staff provide crisis response
				services.
(2)
Performance
				indicators.
a. One or more of the
				following qualifications are met:
(1) A
				mental health professional as defined in Iowa Code section
				228.1.
(2) A bachelor's degree with 30 semester
				hours or equivalent in a human services field (including, but not limited to,
				psychology, social work, nursing, education) and a minimum of one year of
				experience in behavioral or mental health services.
(3) A law enforcement officer with a minimum
				of two years of experience in the law enforcement officer's field.
(4) An emergency medical technician (EMT)
				with a minimum of two years of experience in the EMT's field.
(5) A peer support specialist with a minimum
				of one year of experience in behavioral or mental health services.
(6) A family support peer specialist with a
				minimum of one year of experience in behavioral or mental health
				services.
(7) A registered nurse
				with a minimum of one year of experience in behavioral or mental health
				services.
(8) A bachelor's degree
				in a non-human services-related field, associate's degree, or high school
				diploma (or equivalency) with a minimum of two years of experience in
				behavioral or mental health services, and 30 hours of crisis and mental health
				in-service training (in addition to the required 30 hours of
				department-approved training).
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.25 - Standards for Services

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
				Standard for eligibility. An eligible recipient is an individual experiencing a
				mental health crisis or emergency where a mental health crisis screening is
				needed to determine the appropriate level of care.
(2) Confidentiality and legal status.
				Standards in subrule 24.4(6) are met.
(3) Service systems. Standards in
				subparagraphs 24.4(7)"b "(1) to (3) are met.
(4) Respect for individual rights. Standards
				in subrule 24.4(8) are met.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.26 - Accreditation

Current through Register Vol. 47, No. 3, July 24, 2024
The administrator for the division of mental health and
				  disability services shall determine whether to grant, deny or revoke the
				  accreditation of the centers and services as determined in Iowa Code section
				  225 C. 6(1) "c. "
(1) The
				organization shall meet the standards of subrule 24.5(1), with the addition of
				crisis response service organizations.
(2) The organization shall meet the standards
				in subrules 24.5(2) and 24.5(3).
(3) Performance outcome determinations are as
				follows:
a. Quality assurance staff shall
				determine a performance compliance level based on the number of indicators
				found to be in compliance.
(1) For service
				indicators, if 25 percent or more of the files reviewed do not comply with the
				requirements for a performance indicator, that indicator is considered out of
				compliance and corrective action is required.
(2) Corrective action is required when any
				indicator under policies and procedures or activities is not met.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.27 - Deemed Status

Current through Register Vol. 47, No. 3, July 24, 2024
The department shall grant deemed status to organizations
				  accredited by a recognized national, not-for-profit, accrediting body when the
				  department determines the accreditation is for similar services. The
				  organization shall fulfill the standards described in subrules 24.6(1) to
				  24.6(6). The national accrediting bodies currently recognized as meeting
				  division criteria for possible deeming are:
1. The Joint Commission on Accreditation of
				Healthcare Organizations (JCAHO).
2. The Commission on Accreditation of
				Rehabilitation Facilities (CARF).
3. The Council on Quality and Leadership in
				Supports for People with Disabilities (The Council).
4. The Council on Accreditation of Services
				for Families and Children (COA).
5.
				The American Association of Suicidology (AAS).
6. Contact USA.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.28 - Complaint Process

Current through Register Vol. 47, No. 3, July 24, 2024
The department shall receive and record complaints by
				  individuals using services, employees, any interested people, and the public
				  relating to or alleging violations of applicable requirements of the Iowa Code
				  or administrative rules in accordance with the standards described in rule
				  441-24.7
				  (225C).
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.29 - Appeal Procedure

Current through Register Vol. 47, No. 3, July 24, 2024
The department shall receive appeals according to the process
				  in rule
				  441-24.8
				  (225C).
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.30 - Exceptions to Policy

Current through Register Vol. 47, No. 3, July 24, 2024
The department shall receive exceptions to policy meeting the
				  standards in rule
				  441-24.9
				  (225C).
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.31 - Standards for Individual Crisis Response Services

Current through Register Vol. 47, No. 3, July 24, 2024
Crisis response services provided to children and youth
				  include coordination with parents, guardians, family members, natural supports,
				  and service providers and with other systems such as education, juvenile
				  justice and child welfare.
Crisis response services for individuals who have
				  co-occurring or multi-occurring diagnoses focus on the integration and
				  coordination of treatment services, and supports necessary to stabilize the
				  individual, without regard to which condition is primary. Crisis response
				  services are not to be denied due to the presence of a co-occurring substance
				  abuse condition or developmental or neurodevelopmental
				  disability.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.32 - Crisis Evaluation

Current through Register Vol. 47, No. 3, July 24, 2024
Crisis evaluation consists of two components: crisis
				  screening and crisis assessment.
(1)
				Crisis screening. The purpose of crisis screening is to determine the
				presenting problem and appropriate level of care.
a. Performance benchmark. Crisis screening
				includes a brief assessment of suicide lethality, substance use, alcohol use
				and safety needs. Crisis screening can be provided through contact with crisis
				response staff and through communication with the individual.
b. Performance indicators.
(1) Crisis response staff are trained in
				crisis screening.
(2) A uniform
				process for crisis screening and referrals is outlined in policies and
				procedures.
(3) Crisis screening
				records are kept in individual files.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.33 - Twenty-four-hour Crisis Response

Current through Register Vol. 47, No. 3, July 24, 2024
The purpose of 24-hour crisis response is to provide access
				  to crisis screening and assessment to de-escalate and stabilize the crisis.
				  When the assessment indicates, a stabilization plan is developed to support the
				  individual's return to a prior level of functioning. Twenty-four-hour crisis
				  response staff link the individual to appropriate services. Crisis response
				  staff provide service to individuals of any age.
(1) Performance benchmark. Individuals in
				crisis have the ability to access crisis response services, including, but not
				limited to, crisis screening, crisis assessment and stabilization in the least
				restrictive level of care appropriate.
(2) Performance indicators.
a. Information on how to access 24-hour
				crisis response is publicized to facilitate availability of services to
				individuals using the service, family members and the public.
b. Individuals accessing the service receive
				crisis screening and crisis response services from appropriate crisis response
				staff.
c. Crisis screening is
				available and accessible face-to-face, using telephone or Web-based options, 24
				hours a day, 365 days a year.
d. A
				mental health professional is available for crisis assessment and consultation
				24 hours a day, 365 days a year. The mental health professional has access to a
				qualified prescriber for consultation.
e. The staffing pattern and schedule is
				documented.
f. The integration and
				coordination of care is documented in the individual's record.
g. The discharge, action and follow-up plans
				are documented in the individual's record, and copies of the plans are provided
				to the individual. The family or guardian may receive a copy with a signed
				release.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.34 - Twenty-four-hour Crisis Line

Current through Register Vol. 47, No. 3, July 24, 2024
A 24-hour crisis line provides counseling, crisis service
				  coordination, information and referral, linkage to services and crisis
				  screening. Crisis line staff are qualified to provide crisis stabilization
				  services pursuant to subrule 24.24(2).
(1) Performance benchmark. Crisis screening,
				counseling, crisis service coordination and referrals are provided to
				individuals in crisis.
(2)
				Performance indicators.
a. The crisis line
				service is available 24 hours a day, 365 days a year.
b. Policies are in place regarding how the
				crisis line is answered live, when to utilize the hold feature, the use of
				queue systems and triage of calls.
c. Policies and procedures govern the use of
				technology, including telephonic and Internet capability in the service
				delivery structure, quality assurance, data integrity and
				confidentiality.
d. Procedures are
				in place for ensuring the quality of the crisis line, including monitoring
				calls and corrective action plans.
e. The crisis line is an integrated component
				of the crisis response service system; the crisis line is answered in an
				organization setting by trained crisis response staff.
f. Policies define collaborative efforts and
				triage procedure between the mobile outreach teams, law enforcement and
				emergency services.
g. Policies are
				in place to ensure follow-up contacts are provided within 24 hours of a crisis
				call for all risk cases. The crisis line integrates follow-up into all crisis
				service contacts.
h. The crisis
				line utilizes standardized call center software with the capability to track:
(1) Date and time of answered call, topic of
				call, crisis screening provided, referral made, hold time, and demographics of
				call.
(2) Number of contacts,
				including terminated and lost calls.
i. Policies and procedures describe a uniform
				process of crisis screening and training for crisis line staff.
j. Training includes crisis screening tools,
				lethality assessment, crisis counseling, cultural competence, crisis service
				coordination, and information and referral.
k. Twenty-four-hour access to a mental health
				professional is required.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.35 - Warm Line

Current through Register Vol. 47, No. 3, July 24, 2024
A peer-operated warm line is a service individuals can
				  access to talk with someone with lived experience with mental, behavioral
				  health and trauma issues. The line provides a resource for individuals
				  experiencing emotional distress.
(1)
				Performance benchmark. A warm line provides nonjudgmental listening,
				nondirective assistance, information, referral, and triage when
				appropriate.
(2) Performance
				indicators.
a. Policies are in place
				regarding how the warm line is answered live, placing callers on hold and when
				appropriate to use a queue system.
b. Policies and procedures are in place for
				standard collection of demographics, the presented reason for calling and
				outcome of call.
c. Policies and
				procedures are in place for crisis screening and when to triage a caller to a
				higher level of service.
d. Data
				collection includes call answer times, duration of calls, and number of calls
				dropped, lost or terminated.
e.
				Policies and procedures describe the staffing pattern and schedule.
f. Warm-line staff can receive calls remotely
				through telephones or computers or within an organization.
g. Staff qualifications and training for peer
				support specialists and family support peer specialists are required.
h. Twenty-four-hour access to a mental health
				professional is required.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.36 - Mobile Response

Current through Register Vol. 47, No. 3, July 24, 2024
Crisis response staff provide on-site, in-person
				  intervention for individuals experiencing a mental health crisis. The mobile
				  response staff provide crisis response services in the individual's home or at
				  locations in the community. Staff work in pairs to ensure staff safety and the
				  safety of the individual served. A single staff member may respond if another
				  person who meets one of the criteria listed in paragraph 24.24(2) "a" will be
				  available on site. Twenty-four-hour access to a mental health professional is
				  required.
(1) Performance benchmark.
				Mobile response services are delivered to individuals in crisis in a timely
				manner.
(2) Performance indicators.
a. Mobile response staff are dispatched
				immediately after crisis screening has determined the appropriate level of
				care. If the mobile response staff already are responding to another call,
				staff explain to the caller that there may be a delay in receiving a mobile
				response and offer an alternative response.
b. Mobile response staff have face-to-face
				contact with the individual in crisis within 60 minutes from dispatch. If the
				mobile response staff are responding to another request, there may be a delay
				in receiving mobile response and an alternative response should be
				provided.
c. Data is collected to
				track and trend response time from initial dispatch, the time to respond to
				dispatch when a team is already in response; diversion from or admission to
				hospitals, correctional facilities and other crisis response services. The data
				for each fiscal year is reported to the department within 60 days of the close
				of the fiscal year.
d. When an
				action plan is developed, a copy is sent within 24 hours, with the individual's
				signed consent, to service providers, the individual and others as
				appropriate.
e. The following
				information is documented in the individual's service record:
(1) Triage and referral
				information.
(2) Reduction in the
				level of risk present in the crisis situation.
(3) Coordination with other mental health
				resources.
(4) Names and
				affiliation of all individuals participating in the mobile response.
f. A follow-up appointment with
				the individual's preferred provider will be made, and mobile response staff
				will follow up with the individual and document contact or attempt to contact
				on a periodic basis until the appointment takes place.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.37 - Twenty-three-hour Crisis Observation and Holding

Current through Register Vol. 47, No. 3, July 24, 2024
Twenty-three-hour crisis observation and holding services
				  may be a stand-alone service or embedded within a crisis stabilization
				  residential service. Twenty-three-hour crisis observation and holding services
				  are designed for individuals who need short-term crisis intervention in a safe
				  environment less restrictive than hospitalization. This level of service is
				  appropriate for individuals who require protection or when an individual's
				  ability to cope in the community is severely compromised and it is expected the
				  crisis can be resolved in 23 hours. Twenty-three-hour crisis observation and
				  holding services include, but are not limited to, treatment, medication
				  administration, meeting with extended family or significant others, and
				  referral to appropriate services. Twenty-three-hour crisis observation and
				  holding chairs can be utilized.
(1)
				Admission criteria. The services may be provided if any of the following
				admission criteria are met:
a. There are
				indications the symptoms can be stabilized and an alternative treatment can be
				initiated within a 23-hour period.
b. The presenting crisis cannot be safely
				evaluated or managed in a less restrictive setting, or no such setting is
				available.
c. The individual does
				not meet inpatient criteria, and it is determined a period of observation
				assists in the stabilization and prevention of symptom exacerbation.
d. Further evaluation is necessary to
				determine the individual's service needs.
e. There is an indication of actual or
				potential danger to self or others as evidenced by a current threat or
				ideation.
f. There is a loss of
				impulse control leading to life-threatening behavior and other psychiatric
				symptoms requiring stabilization in a structured, monitored setting.
g. The individual is experiencing a crisis
				demonstrated by an abrupt or substantial change in normal life functioning
				brought on by a specific cause, sudden event or severe stressor.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.38 - Crisis Stabilization Community-based Services (CSCBS)

Current through Register Vol. 47, No. 3, July 24, 2024
The goal of CSCBS is to stabilize the individual within the
				  community. CSCBS is designed as a voluntary service for individuals in need of
				  a safe, secure location that is less intensive and restrictive than an
				  inpatient hospital. Individuals receive CSCBS services including, but not
				  limited to, psychiatric services, medication, counseling, referrals, peer
				  support and linkage to ongoing services. The duration for CSCBS is expected to
				  be less than five days.
(1)
				Eligibility. To be eligible, an individual must:
a. Be determined appropriate for the service
				by mental health assessment; and
b.
				Be determined not to need inpatient acute hospital psychiatric
				services.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.39 - Crisis Stabilization Residential Services (CSRS)

Current through Register Vol. 47, No. 3, July 24, 2024
Crisis stabilization residential services are short-term
				  services provided in facility-based settings of no more than 16 beds. The goal
				  of CSRS is to stabilize and reintegrate the individual back into the community.
				  Crisis stabilization residential services are designed for voluntary
				  individuals who are in need of a safe, secure environment less intensive and
				  restrictive than an inpatient hospital. Crisis stabilization residential
				  services have the capacity to serve more than two individuals at a time. Crisis
				  stabilization residential services can be for youth aged 18 and younger or
				  adults aged 18 and older. Youth and adults cannot be housed in the same
				  facility setting. Facilities licensed by the department of inspections and
				  appeals for other services would have to comply with the provisions of Iowa
				  Administrative Code rule
				  481-57.50
				  (135C) for operating another business or activity in the facility.
(1) Eligibility. To be eligible, an
				individual must:
a. Be an adult aged 18 or
				older or a youth aged 18 or under.
b. Be determined appropriate for the service
				by a mental health assessment; and
c. Be determined to not need inpatient acute
				hospital psychiatric services.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.40 - Medication-administration, Storage and Documentation

Current through Register Vol. 47, No. 3, July 24, 2024
This rule sets forth medication requirements for 23-hour
				  crisis observation and holding, crisis stabilization community-based services,
				  and crisis stabilization residential services.
(1)
Performance benchmark.
Policies and procedures ensure prescription and over-the-counter drugs are
				administered or self-administered safely and properly in accordance with
				federal, state and local laws and regulations. Medication is administered by a
				qualified prescriber or an individual following the instructions of a qualified
				prescriber. Medication storage is maintained in accordance with the security
				requirements of federal, state and local laws. Case records include written
				policies and procedures regarding use of medication.
(2)
Performance indicators.
a.
Administration of
				medication.
(1) Medication
				administration dose schedules and standardization of abbreviations are
				documented.
(2) Throughout the CSRS
				specific methods for control and accountability of medication products are
				established.
(3) Prescription and
				over-the-counter drugs are administered or self-administered safely and
				properly in accordance with federal, state and local laws and
				regulations.
(4) Medications are
				prescribed by a qualified prescriber under Iowa law.
(5) Prescription drugs are not administered
				or self-administered without a written order signed by a qualified
				prescriber.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.50 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
"Catchment area"
means the same as defined
				  in Iowa Code section
				  230A.102(2).
"Community mental health center
				  self-assessment"
means the form completed and submitted to the
				  department by a new organization as part of the initial application to be
				  designated as a CMHC. Designated CMHCs complete the form annually and submit it
				  to the department as part of the accreditation and CMHC monitoring
				  process.
"Community support services"
or
"CSS"
means services that support individuals with a mental
				  illness and functional impairment to live and work in the community of their
				  choice through assisting with:
1. Monitoring of mental health symptoms and
				  functioning/reality orientation;
2. Transportation;
3. Supportive relationship;
4. Communication with other providers;
5. Ensuring individual attends appointments/obtains
				  medications;
6. Crisis intervention/developing crisis plan; and
7. Coordination and development of natural support systems
				  for mental health support.
"Functional impairment,"
for the purpose of
				  this division, means difficulties that substantially interfere with or limit
				  functioning in one or more major life activities, such as basic daily living
				  (including but not limited to eating, bathing, dressing); instrumental living
				  skills (including but not limited to maintaining a household, managing money,
				  community involvement, taking prescribed medication); and functioning in
				  social, family and vocational/educational contexts.
"Psychosocial rehabilitation services"
means
				  services that promote recovery, full community integration, and improved
				  quality of life for persons who have been diagnosed with any mental health
				  condition that seriously impairs their ability to lead meaningful lives.
				  Psychosocial rehabilitation services are collaborative, person-directed and
				  individualized. The service focuses on helping individuals develop skills and
				  access resources needed to increase their capacity to be successful and
				  satisfied in the living, working, learning, and social environments of their
				  choice.
"Target population"
means the same as
				  defined in Iowa Code section
				  230A.105.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.51 - Community Mental Health Center Designation

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Application.
An
				organization seeking designation as a community mental health center or a
				designated community mental health center seeking to expand its designated
				catchment area shall submit the following to the department:
a. Form 470-3005, Accreditation Application,
				if requesting accreditation for a CMHC core service(s) other than outpatient
				psychotherapy and evaluation.
b.
				Form 470-5691, Community Mental Health Center Designation, signed by the
				organization's chief executive officer and the chairperson of the governing
				body.
c. Form 470-5692, Community
				Mental Health Center Self-Assessment.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.52 - Standards for Policies and Procedures

Current through Register Vol. 47, No. 3, July 24, 2024
Policies and procedures manuals shall include policy
				  guidelines and administrative procedures for:
1. Core services and supports,
2. Serving the target population with minimal
				to no service denials,
3.
				Addressing the standards in rule
				441-24.2 (225), and
4. Ensuring an individual's ability to access
				services regardless of ability to pay. The CMHC shall assist individuals with
				applying for health insurance and MHDS regional assistance when necessary to
				ensure access to services.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.53 - Standards for Organizational Activities

Current through Register Vol. 47, No. 3, July 24, 2024
The organization shall meet all requirements in rule
				  441-24.3 (225C) and the
				  standards identified in this rule.
(1)
				A CMHC organized as a nonprofit corporation shall be governed by a board of
				directors consistent with the requirements identified in Iowa Code section
				230A.110(3)
"b."
(2) A CMHC organized as a for-profit
				corporation shall have a policy structure that incorporates the representation
				identified in Iowa Code section
				230A.110(3)
"b."
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.54 - Standards for Core Services and Supports

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Outpatient services.
Outpatient services include outpatient psychotherapy and counseling services
				and evaluation. These services are to be provided directly by the CMHC.
a. Outpatient psychotherapy and counseling
				services shall be provided in accordance with subrule 24.4(14) and shall
				include treatment modalities and evidence-based practices for children, adults,
				older adults, individuals with co-occurring conditions, and individuals
				discharged from inpatient settings. Clinical eligibility is determined at the
				time of initial assessment and annually thereafter in accordance with subrule
				24.4(2).
b. Evaluation services
				shall be provided in accordance with subrule 24.4(16).
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 24 - Accreditation of Providers of Services to Persons With Mental Illness, Intellectual Disabilities, or Developmental Disabilities › Rule 441-24.55 - Accreditation of Community Mental Health Centers

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The provider shall be accredited as a
				provider of outpatient psychotherapy and counseling pursuant to subrule
				24.4(14) and evaluation pursuant to subrule 24.4(16) and meet the standards of
				rule 441-24.3 (225C).
(2) The provider shall meet the standards in
				rules 441-24.52 (230A), 441-24.53 (230A), and 441-24.54 (230A). Corrective
				action is required when any indicator under community mental health designation
				standards is not met.
(3) The
				provider shall annually submit Form 470-5692, Community Mental Health Center
				Self-Assessment, to the department.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 25 - Disability Services Management › Rule 441-25.2 - Core Service Domains

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The region shall ensure that core service
				domains are available in regions as determined in Iowa Code sections
				331.397
				and
				331.397A.
(2) The region shall include and respect the
				recommendation of the individual and the individual's care team in the process
				of transition to new services.
(3)
				The region shall ensure that the following services are available for adults in
				the region:
a. Access centers.
b. Assertive community treatment.
c. Assessment and evaluation.
d. Case management.
e. Crisis evaluation.
f. Crisis stabilization community-based
				services.
g. Crisis stabilization
				residential services.
h. Day
				habilitation.
i. Family
				support.
j. Health homes.
k. Home and vehicle modification. /. Home
				health aide.
m. Intensive
				residential service homes.
n. Job
				development.
o. Medication
				prescribing and management.
p.
				Mental health inpatient treatment.
q. Mental health outpatient
				treatment.
r. Mobile
				response.
s. Peer
				support.
t. Personal emergency
				response system.
u. Prevocational
				services.
v. Respite.
w. Subacute mental health services.
x. Supported employment.
y. Supportive community living.
z. Twenty-four-hour access to crisis
				response.
aa. Twenty-three-hour
				crisis observation and holding.
Regions may fund or provide other services in addition to the
				  required core services consistent with requirements set forth in subrules
				  25.2(5) and 25.2(6).
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 25 - Disability Services Management › Rule 441-25.2 - Core Service Domains

Current through Register Vol. 47, No. 3, July 24, 2024
(1) The
				region shall ensure that core service domains are available in regions as
				determined in Iowa Code sections
				225C.65 and
				225C.66.
(2) The region shall include and respect the
				recommendation of the individual and the individual's care team in the process
				of transition to new services.
(3)
				The region shall ensure that the following services are available for adults in
				the region:
a. Access centers.
b. Assertive community treatment.
c. Assessment and evaluation.
d. Case management.
e. Crisis evaluation.
f. Crisis stabilization community-based
				services.
g. Crisis stabilization
				residential services.
h. Day
				habilitation.
i. Family
				support.
j. Health homes.
k. Home and vehicle modification.
l. Home health aide.
m. Intensive residential service
				homes.
n. Job
				development.
o. Medication
				prescribing and management.
p.
				Mental health inpatient treatment.
q. Mental health outpatient
				treatment.
r. Mobile
				response.
s. Outpatient competency
				restoration.
t. Peer
				support.
u. Personal emergency
				response system.
v. Prevocational
				services.
w. Respite.
x. Subacute mental health services.
y. Supported employment.
z. Supportive community living.
aa. Twenty-four-hour access to crisis
				response.
bb. Twenty-three-hour
				crisis observation and holding.
Regions may fund or provide other services in addition to the
				  required core services consistent with requirements set forth in subrules
				  25.2(5) and 25.2(6).
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 25 - Disability Services Management › Rule 441-25.4 - Access Standards

Current through Register Vol. 47, No. 3, July 24, 2024
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.