Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES › Chapter 32 - CHILDREN'S MENTAL HEALTH AND SUBSTANCE USE TREATMENT SERVICES › Section 471-32-006 - Treatment Group Home

Current through June 17, 2024
006.01 Introduction and Legal Basis
Treatment group home services are available to clients age 20 or
	 younger when the client has participated in a HEALTH CHECK (EPSDT) screen, the
	 treatment is clinically necessary, and the need for this level of care has been
	 identified as part of an Initial Diagnostic Interview. Treatment group homes
	 are non-hospital based treatment services that are community-based,
	 family-centered, and culturally competent.
Treatment group home services for children and adolescents covered by
	 Medicaid include treatment group home services for children age 20 and younger
	 who are eligible for Medicaid. The policy in this section also covers children
	 age 18 or younger who are wards of the Department.
Treatment group home services must be recommended by a licensed
	 practitioner of the healing arts who is able to diagnose and treat major mental
	 illness within his/her scope of practice for reduction of physical or mental
	 disability, to restore a recipient to a better level of functioning, and to
	 facilitate discharge to a less restrictive level of care.
006.02 Treatment Group Home Services for
  Children
The Department's philosophy is that all care provided to clients must
	 be provided at the least restrictive and most appropriate level of care. Care
	 must be developmentally appropriate, family-centered, culturally competent and
	 community based. It must directly involve the immediate family in all phases of
	 treatment and discharge planning. Family may include biological, step, foster,
	 or adoptive parents, sibling or half sibling, and extended family members as
	 appropriate.
Providers must encourage family members to be involved in the
	 assessment of the client, the development of the treatment plan, and all
	 aspects of the client's treatment unless prohibited by the client, through
	 legal action, or because of federal confidentiality laws.
Providers must be available to schedule meetings and sessions in a
	 flexible manner to accommodate and work with a family's schedule. This includes
	 the ability to schedule sessions at a variety of times including weekends or
	 evenings.
The provider must document their attempts to involve the family in
	 treatment plan development and treatment plan reviews. A variety of
	 communication means should be considered. These may include, but should not be
	 limited to, including the family via conference telephone calls, using
	 registered letters to notify the family of meetings, and scheduling meetings in
	 the evening and on weekends.
Care must involve a representative from the appropriate home community
	 service providers. This may include such areas as education, social services,
	 law enforcement, religion, medical, and mental health professionals. NMAP will
	 cover more restrictive levels of care only when all other resources have been
	 explored and deemed to be inappropriate. If hospital-based inpatient care is
	 deemed appropriate, see 471 NAC
	 32-008. If psychiatric residential
	 treatment services are deemed appropriate, see 471 NAC
	 32-007.
To ensure a less institutional setting, each location where children
	 are housed can serve no more than 2 units of up to 20 beds. Facilities may have
	 up to two crisis intervention beds per unit (see
	 32-003 Treatment Crisis Intervention)
	 and the facility must provide a home-like atmosphere.
006.03 Standards for Participation for
  Treatment Group Home Services
32-006.03A
Provider Agreement
: A provider of treatment group home
  services shall complete Form MC-19 or MC-20, "Medical Assistance Provider
  Agreement," and submit the completed form to the Department for approval. The
  Department is the sole determiner of which facilities are approved for
  participation in this program. The facility will be advised in writing when its
  participation is approved.
The provider shall submit the following with Form MC-19 or
	 MC-20:
1. A written overview of the
  program's philosophy and objectives of treating children and youth including:
a. A complete description of how the
  family-centered requirement will be met, including a complete description of
  any home-based family therapy services;
b. A complete description of how the
  community-based requirement will be met;
c. A description of each available
  service;
d. A list of treatment
  modalities available and the capacity for individualized treatment
  planning;
e. A statement of the
  qualification, education, and experience of each staff member providing
  treatment and the therapy service each provides;
f. A schedule covering the total number of
  hours that the program operates;
g.
  The Department approved cost reporting document; and
h. The target population.