Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.19 - Minimum Standards for Mental Health Centers › Rule 37.106.1946 - MENTAL HEALTH CENTER: INPATIENT CRISIS STABILIZATION PROGRAM

Current through Register Vol. 13, July 5, 2024
(1) In addition to the requirements
				established in this subchapter, each mental health center providing an
				inpatient crisis stabilization program shall comply with the requirements
				established in this rule.
(2) The
				facility must be annually inspected for compliance with fire codes by the state
				fire marshal or the marshal's designee. The facility shall maintain a record of
				such inspection for at least one year following the date of the
				inspection.
(3) The inpatient
				crisis stabilization program shall:
(a)
				employ or contract with a program supervisor knowledgeable about the service
				and support needs of individuals with mental illness experiencing a crisis. The
				program supervisor or a licensed mental health professional must be site
				based;
(b) require staff working in
				the crisis stabilization program:
(i) be 18
				years of age;
(ii) possess a high
				school diploma or GED; and
(iii) be
				capable of implementing each resident's treatment plan;
(c) ensure that the program supervisor and
				all staff each have a minimum of six contact hours of annual training relating
				to the service and support needs of individuals with mental illness
				experiencing a crisis;
(d) orient
				staff prior to assuming the duties of the position on:
(i) the types of mental illness and treatment
				approaches;
(ii) suicide risk
				assessment and prevention procedures; and
(iii) program policies and procedures,
				including emergency procedures;
(e) orient staff within eight weeks from
				assuming the duties of the position on:
(i)
				therapeutic communications;
(ii)
				the legal responsibilities of mental health service providers;
(iii) mental health laws of Montana regarding
				the rights of consumers;
(iv) other
				services provided by the mental health center; and
(v) infection control and prevention of
				transmission of blood borne pathogens;
(f) maintain written program policies and
				procedures at the facility;
(g)
				train staff in the abdominal thrust maneuver and ensure staff maintain current
				certification in cardiopulmonary resuscitation (CPR);
(h) maintain 24 hour awake staff;
(i) maintain a staff-to-patient ratio
				dictated by resident need. A procedure must be established to increase or
				decrease staff coverage as indicated by resident need;
(j) establish admission criteria which assess
				the individual's needs and the appropriateness of the services to meet those
				needs. At a minimum, admission criteria must require that the person:
(i) be at least 18 years of age;
(ii) be medically stable (with the exception
				of the person's mental illness);
(iii) be willing to enter the program, follow
				program rules, and accept recommended treatment;
(iv) be willing to sign a no-harm contract,
				if clinically indicated;
(v) not
				require physical or mechanical restraint;
(vi) be in need of frequent observation on a
				24-hour basis;
(k)
				establish written policies and procedures:
(i) for completing a medical screening and
				establishing medical stabilization, prior to admission;
(ii) to be followed should residents,
				considered to be at risk for harming themselves or others, attempt to leave the
				facility without discharge authorization from the licensed mental health
				professional responsible for their treatment; and
(iii) for the secure storage of toxic
				household chemicals and sharp household items such as utensils and
				tools;
(l) when
				clinically appropriate, provide each resident upon admission, or as soon as
				possible thereafter:
(i) a written statement
				of resident rights which, at a minimum, include the applicable patient rights
				in
				53-21-142,
				MCA;
(ii) a copy of the mental
				health center grievance procedure; and
(iii) the written rules of conduct including
				the consequences for violating the rules;
(m) ensure hospital care is available through
				a transfer agreement for residents in need of hospitalization;
(n) maintain progress notes for each
				resident. The progress notes must be entered at least daily into the resident's
				clinical record. The progress notes must describe the resident's physical
				condition, mental status, and involvement in treatment services; and
(o) make referrals for services that would
				help prevent or diminish future crises at the time of the resident's discharge.
				Referrals may be made for the resident to receive additional treatment or
				training or assistance such as securing housing.