Code of Maine Rules › 14 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 193 - OFFICE OF ADULT MENTAL HEALTH › Chapter 6 - MENTAL HEALTH LICENSING REGULATIONS › EMERGENCY SERVICE STANDARDS

Current through 2024-29, July 17, 2024
These standards, in addition to the core standards, are
				  applied to agencies providing emergency services.
Assessment
EM.1 There is documented evidence that the results of the
				  assessment are discussed with the individual and/or the legally responsible
				  party as appropriate.
Interpretive Guideline for EM.1
If the results are not discussed with the client or legally
				  responsible party, the agency documents the reason(s) for not communicating
				  this information.
Emergency Services
EM.2 A plan will be developed through an assessment of the
				  client's immediate treatment, supervision, and support needs.
EM. 2. A. There is documented evidence that the agency
				  assesses the individuals they serve.
Em. 2. B Every record of emergency contact or set of contacts
				  around a particular incident will include documentation of the:
EM. 2. B.1 presenting problem;
EM. 2. B.2 history and precipitating factors;
EM. 2. B.3 assessing capacity to make reasoned decisions,
				  danger to self or others, and ability to care for self; and
EM. 2. B.4 disposition, including referrals to other services
				  as appropriate and indicated.
EM. 2. C. In instances in which the emergency services
				  personnel are aware that the client receives community' support services and/or
				  has an Individualized Support Plan, the agency shall, subject to the client's
				  consent and the availability of the community support worker, coordinate the
				  assessment and planning with the community support worker.
EM. 2. C.1 Services provided to these clients will be
				  consistent with the targets and objectives of the Individualized Support
				  Plan.
Interpretive Guideline for EM.2
A client's refusal or inability to consent is documented in
				  the client record.
EM.3 Crisis and emergency workers shall collaborate with the
				  client and the client's community support worker, if available, to determine
				  the most appropriate, least restrictive environment for the client's
				  stabilization and indicate this collaboration in progress notes.
Interpretive Guideline for EM.3
Crisis and emergency workers shall consider four options in
				  priority order for least restrictive environment:
1. return to client's home or home of a family member or
				  friend with or without additional out-patient on in-home treatment
				  services;
2. stabilization in a short-term supported bed;
3. voluntary admission to a psychiatric facility; or
4. hospitalization in a secure facility.
EM.4 The agency has documented evidence that trained
				  intervention personnel have consultation services of a psychologist or a
				  psychiatrist available to them at all times.
EM.5 The agency maintains contact/progress notes on each
				  client that include follow-up evaluations on the outcome of services and
				  referrals.
EM.6 Crisis services shall be delivered in a timely fashion
				  and be available 24 hours per day, seven days per week.
EM. 6. A. Trained crisis workers are available at all times
				  through face-to face or phone contact.
EM. 6. B. The agency determines criteria 'for timeliness and
				  monitors compliance with these criteria by documenting when a request for
				  emergency service is made and when emergency services are delivered.
EM. 6. C. There are no substantiated complaints regarding
				  access to emergency services. All substantiated complaints will be assessed for
				  the seriousness of the violation and actions taken to achieve
				  compliance.
EM.7 The agency has the capacity to provide face-to-face
				  contact during normal business hours.
EM. 7. A. There are no substantiated complaints regarding
				  refusal of face-to- face contact during normal business hours. All
				  substantiated complaints will be assessed for the seriousness of the violation
				  and actions taken to achieve compliance.
EM.8 All agencies have a capability, either directly or
				  through arrangement, to assure face-to-face contacts off-site when
				  necessary.
EM. 8. A. Agencies will have a written policy and procedure
				  regarding steps to be taken when face-to-face contact with the client appears
				  necessary. This document should minimally include procedures for contacting
				  emergency service providers, e.g., police, EMT's, rescue, mobile crisis teams,
				  or other professional emergency response organizations.
Em. 8. B. All crisis service agencies have access to
				  personnel capable of processing involuntary hospitalizations, either directly
				  or through written agreements.
EM.9 The agency has written criteria for follow-up contacts
				  with clients who are at risk and documents these contacts in the client
				  records.
EM. 9. A. Follow-up contacts are documented in the client's
				  record and comply with confidentiality and informed consent standards.
Interpretive Guideline for EM.9
There are written criteria describing the process for
				  follow-up contacts with clients at risk. This may include, but is not
				  necessarily limited to the following: contacting other agencies, encouraging
				  clients to call back and directly calling clients who consent to such
				  follow-up.
EM.10. The agency develops intervention plans for clients
				  with frequent or special needs.
EM. 10. A. The agency has written criteria and a process for
				  developing intervention plans based upon frequency of contacts and acuity of
				  needs.
EM. 10. A.1 Then is documented evidence that the intervention
				  plan is developed with the participation of the client, legally responsible
				  party and other representatives and professionals whom the client
				  designates.
EM. 10. A.2. Clients shall under no circumstances be denied
				  access to emergency services due to failure to comply with an intervention plan
				  nor shall intervention plan be used to restrict access to emergency
				  services.
EM. 10. B. There is documented evidence that intervention
				  plans are periodically reviewed.
EM.11 There are written procedures to access rescue services,
				  including a plan to update resource listings routinely.
EM. 11. A. There is documented evidence that rescue
				  procedures are routinely followed and are systematically revised and
				  updated.
EM. 11. B. There is evidence that staff members are trained
				  in the agency's rescue procedures.
EM.12 The agency as documented evidence that services to
				  victims/survivors of rape/incest are either provided directly or through
				  referral.
EM. 12. A. If services are provided by the agency, there is
				  documented evidence that staff members have received training relative to these
				  services.
EM. 12. B. If services are not provided directly by the
				  agency, the agency has a written policy and procedure regarding referral of
				  these clients to a provider of these services.
EM.13 Crisis or emergency workers shall be licensed or
				  certified to deliver mental health services in the State and have additional
				  training in the delivery of emergency services.