reglab/statecodes huggingface dataset:
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 37.106.1950 - MENTAL HEALTH CENTER: MEDICATION MANAGEMENT SERVICES

Current through Register Vol. 13, July 5, 2024
(1) Each mental health center shall make
				medication management services available to the clients it serves for
				medications needed to treat their mental illnesses.
(2) Medication management services shall be
				provided by licensed health care professionals, acting within the scope of
				their licenses, who are either employed by or contracted with the mental health
				center.
(3) A mental health center
				shall have medication management policies and procedures in its policy
				procedure manual which include, at minimum, the following:
(a) maintaining a current, chronological and
				dated record of medication orders by the client's licensed health care
				professional in the client's clinical records;
(b) self-administration of medications by
				clients;
(c) administering client
				prescription and over-the-counter medications by licensed health care
				professionals;
(d) adjusting
				dosages or prescribing new medications for clients to include the rationale for
				the use of and changes in the client's medication;
(e) monitoring the client's response to
				medication or dosage changes;
(f)
				maintaining a medication administration record for each client documenting
				medications and dosages prescribed, the client's compliance in taking
				prescribed medications, doses taken or not taken, any measure taken to obtain
				compliance, and the reason for omission of any scheduled dose of
				medication;
(g) documenting any
				medication errors;
(h) reporting
				and addressing in a timely manner, any medication errors and adverse drug
				reactions to the licensed health care professional who prescribed the client's
				medication, and to the program supervisor and medical director;
(i) providing and documenting education about
				the effects, side effects, contraindications and management procedures of the
				client's medication;
(j) providing
				safe and secure storage of all medications;
(k) providing refrigeration for medication
				segregated from food items, within the temperature range specified by the
				manufacturer for medication that requires refrigeration; and
(l) storing medication in the container
				dispensed by the pharmacy or in the container in which it was purchased in the
				case of over-the-counter medication, with the label intact and clearly
				legible.
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 37.106.1955 - MENTAL HEALTH CENTER: COMPREHENSIVE SCHOOL AND COMMUNITY TREATMENT PROGRAM (CSCT) ENDORSEMENT REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) In addition to
				the requirements established in this subchapter, a licensed mental health
				center providing a comprehensive school and community treatment program (CSCT)
				must have a CSCT program endorsement issued by the department. To receive a
				CSCT program endorsement, the licensed mental health center must establish to
				the department's satisfaction that it meets the requirements stated in ARM
				37.106.1955,
				37.106.1956,
				37.106.1960,
				37.106.1961,
				and
				37.106.1965.
(2) The licensed mental health center's CSCT
				program must have written admission and discharge criteria.
(3) The licensed mental health center must
				have a written contract with the school district in accordance with ARM
				37.87.1802.
AUTH:
					 53-2-201,
					 53-6-113,
					 MCA; IMP:
					 50-5-103,
					 53-2-201,
					 53-6-101,
					 53-6-111,
					 53-6-113,
					 MCA
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 37.106.1956 - MENTAL HEALTH CENTER: COMPREHENSIVE SCHOOL AND COMMUNITY TREATMENT PROGRAM (CSCT), SERVICES AND STAFFING

Current through Register Vol. 13, July 5, 2024
(1) For any youth
				receiving CSCT services, the CSCT program must be able to provide the following
				services to each youth as specified in that youth's individualized treatment
				plan (ITP):
(a) individual, group, and family
				therapy;
(b) remains the
				same.
(c) other evidence and
				research-based practices effective in the treatment of youth with a serious
				emotional disturbance (SED);
(d)
				direct crisis intervention services during the time the youth is present in a
				school-owned or operated facility;
(e) a crisis plan that identifies a range of
				potential crisis situations with a range of corresponding responses including
				physically present face-to-face encounters and telephonic responses 24/7, as
				appropriate;
(f) treatment plan
				coordination with substance use disorder and mental health treatment services
				the youth receives outside the CSCT program;
(g) access to emergency services;
(h) referral and aftercare coordination with
				inpatient facilities, psychiatric residential treatment facilities, or other
				appropriate out-of-home placement programs; and
(i) continuous treatment that must be
				available twelve months of the year. The program must provide a minimum of four
				service days per month of CSCT services in summer months. For any youth who
				does not receive CSCT services in the summer, providers must document in the
				youth's medical record the reason why the youth did not receive such services,
				as well as a summary of attempts to engage the youth and family.
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 37.106.1960 - MENTAL HEALTH CENTER: COMPREHENSIVE SCHOOL AND COMMUNITY TREATMENT (CSCT) PROGRAM, PERSONNEL TRAINING

Current through Register Vol. 13, July 5, 2024
(1) The CSCT
				program must be delivered by adequately trained staff. Training should be
				competency-based and must be documented and maintained in personnel
				files.
(2) All CSCT program staff
				are required to receive a minimum of 18 hours of orientation training during
				the first three months of employment which addresses all of the following:
(a) certified de-escalation training
				inclusive of physical and nonphysical methods;
(b) child development;
(c) behavior management;
(d) crisis planning;
(e) roles and responsibilities of CSCT staff
				in the school setting;
(f) school
				culture;
(g) confidentiality
				requirements;
(h) staff and
				program supervision; and
(i) CSCT
				program procedures.
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 37.106.1961 - MENTAL HEALTH CENTER: COMPREHENSIVE SCHOOL AND COMMUNITY TREATMENT (CSCT) PROGRAM, RECORD REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) In addition to
				any clinical records required in ARM
				37.85.414
				or elsewhere in these rules, the licensed mental health center's CSCT program
				must maintain the following records for youth with serious emotional
				disturbance (SED):
(a) a signed verification
				indicating the parent(s), legal representative, or guardian has been informed
				by the licensed mental health center that Medicaid requires coordination
				between CSCT, home support services, and outpatient therapy;
(b) a copy of the clinical assessment which
				documents the presence of SED;
(c)
				the individualized treatment plan for CSCT;
(d) daily progress notes from each team
				member that document individual therapy sessions and other direct services
				provided to the youth and family throughout the day including:
(i) when any therapy or therapeutic
				intervention begins and ends; and
(ii) the sum total number of minutes spent
				each day with the youth.
(e) 90-day treatment plan reviews;
(f) discharge plan ; and
(g) the Comprehensive School and Community
				Treatment Data Collection Template, that must be completed each March and
				September for each youth enrolled in CSCT and submitted to the Children's
				Mental Health Bureau by the licensed mental health center. The department
				adopts and incorporates by reference the Comprehensive School and Community
				Treatment Data Collection Template (form), dated November 1, 2021. A copy of
				this form may be obtained from the department by a request in writing to the
				Department of Public Health and Human Services, Developmental Services
				Division, Children's Mental Health Bureau, 111 N. Sanders, P.O. Box 4210,
				Helena, MT, 59604-4210 or at found at
https://dphhs.mt.gov/dsd/CMB/
.
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 37.106.1965 - MENTAL HEALTH CENTER: COMPREHENSIVE SCHOOL AND COMMUNITY TREATMENT (CSCT) PROGRAM, SPECIAL EDUCATION REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) The
				licensed mental health center's CSCT program must be coordinated with the
				individualized education program (IEP) of the youth, if the youth is identified
				as a child with a disability and is receiving special education services under
				the Individuals with Disabilities Education Act (IDEA).
(2) The licensed or in-training mental health
				professional or behavioral aide, as appropriate, must attend the IEP meeting
				when requested by the parent(s)/legal representative/guardian or the
				school.
AUTH:
					 53-2-201,
					 53-6-113,
					 MCA; IMP:
					 50-5-103,
					 53-2-201,
					 53-6-101,
					 53-6-111,
					 53-6-113,
					 MCA
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 37.106.1975 - OUTPATIENT CRISIS RESPONSE FACILITY: APPLICATION OF OTHER RULES

Current through Register Vol. 13, July 5, 2024
(1) To the extent that other licensure rules
				in ARM Title 37, chapter 106, subchapter 3, conflict with the terms of this
				subchapter, the terms of this subchapter will apply to outpatient crisis
				response facilities.
50-5-103,
					 MCA; IMP,
					 50-5-103,
					 MCA;
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 37.106.1976 - OUTPATIENT CRISIS RESPONSE FACILITY: DEFINITIONS

Current through Register Vol. 13, July 5, 2024
In addition to the definitions in
				  50-5-101,
				  MCA, the following definitions apply to this subchapter:
(1) "Inpatient crisis stabilization program"
				means 24-hour supervised treatment for adults with a mental illness for the
				purpose of stabilizing the individual's symptoms.
(2) "Outpatient crisis response facility"
				means an outpatient facility operated by a licensed hospital or a licensed
				mental health center that provides evaluation, intervention, and referral for
				individuals experiencing a crisis due to serious mental illness or a serious
				mental illness with a co-occurring substance use disorder. The facility may not
				provide services to a client for more than 23 hours and 59 minutes from the
				time the client arrives at the facility. The facility must discharge or
				transfer the client to the appropriate level of care.
50-5-103,
					 MCA; IMP,
					 50-5-103,
					 MCA;
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 37.106.1979 - OUTPATIENT CRISIS RESPONSE FACILITY: SERVICES AND LICENSURE

Current through Register Vol. 13, July 5, 2024
(1) Each applicant for licensure shall submit
				a license application to the department requesting approval to provide
				outpatient crisis services.
(a) A licensed
				hospital does not have to comply with the requirements found at ARM
				37.106.1906(3) to
				provide outpatient crisis response services.
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 37.106.1980 - OUTPATIENT CRISIS RESPONSE FACILITY: ORGANIZATIONAL STRUCTURE

Current through Register Vol. 13, July 5, 2024
(1) Each crisis response facility shall
				employ or contract with an administrator who shall:
(a) maintain daily overall responsibility for
				the crisis response facility's operations;
(b) develop and oversee the implementation of
				policies and procedures pertaining to the operation and services of the crisis
				response facility;
(c) establish
				written orientation and training procedures for all employees including new
				employees, relief workers, temporary employees, students, interns, volunteers,
				and trainees. The training must include orientation on all the crisis response
				facility's policies and procedures;
(d) develop an organizational chart that
				accurately reflects the current lines of administration and authority;
				and
(e) maintain a file for all
				client incident reports.
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 37.106.1981 - OUTPATIENT CRISIS RESPONSE FACILITY: STAFFING AND OPERATIONS

Current through Register Vol. 13, July 5, 2024
(1) In addition to the requirements
				established in this subchapter, each outpatient crisis response facility shall
				comply with the requirements established in this rule. The outpatient crisis
				response facility shall require staff working in the facility:
(a) to be at least 18 years of age;
(b) possess a high school diploma or GED;
				and
(c) be capable of implementing
				each client's crisis facility treatment plan.
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 37.106.1982 - OUTPATIENT CRISIS RESPONSE FACILITY: POLICIES AND PROCEDURES

Current through Register Vol. 13, July 5, 2024
(1) Each outpatient crisis response facility
				shall maintain a policy and procedure manual. The manual must be reviewed and
				approved, at least annually, by the medical director and administrator. The
				manual must, at a minimum, contain policies and procedures for:
(a) defining the responsibilities,
				limitations, and supervision of students, interns, and volunteers working for
				the crisis response facility;
(b)
				verifying each professional staff member's credentials, when hired, and
				annually thereafter, to ensure the continued validity of required
				licenses;
(c) client complaints and
				grievances, to include an opportunity for appeal, and to inform clients of the
				availability of advocacy organizations to assist them;
(d) completing a medical screening and
				determining methods for medical stabilization and criteria for transfer to
				appropriate level of medical care that may include emergency care in a
				hospital;
(e) interacting with
				clients considered to be at risk for harming themselves or others who attempt
				to leave the facility without discharge authorization from the licensed mental
				health professional responsible for their treatment;
(f) increasing or decreasing staff coverage
				as indicated by client need;
(g)
				identifying client rights, including a procedure for informing clients of their
				rights;
(h) addressing and
				reviewing ethical issues faced by staff and reporting allegations of ethics
				violations to the applicable professional licensing authority;
(i) informing clients of the policy and
				procedures for client complaints and grievances;
(j) initiating services to clients;
(k) informing clients of rules governing
				their conduct and the types of infractions that can result in suspension or
				discontinuation of services offered by the crisis response facility;
(l) suspending or discontinuing program
				services with the following information to be provided to the client:
(i) the reason for suspending or
				discontinuing services or access to programs;
(ii) the conditions that must be met to
				resume services or access to programs;
(iii) the grievance procedure that may be
				used to appeal the suspension or discontinuation; and
(iv) what services, if any, will be continued
				to be provided even though participation in a particular service or program may
				be suspended or discontinued.
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 37.106.1983 - OUTPATIENT CRISIS RESPONSE FACILITY: CLINICAL RECORDS

Current through Register Vol. 13, July 5, 2024
(1) Each crisis response facility shall
				collect assessment data and maintain clinical records on all clients who
				receive services.
(2) Each facility
				must ensure the confidentiality of clinical records in accordance with the
				Health Information Portability and Accountability Act (HIPAA).
(3) At a minimum, the clinical record must
				include:
(a) a clinical intake
				assessment;
(b) additional
				assessments or evaluations, if clinically indicated;
(c) a copy of the client's individualized
				crisis treatment plan and all modifications to the crisis treatment
				plan;
(d) progress notes which
				indicate whether or not the stated treatment plan has been implemented, and the
				degree to which the client is progressing, or failing to progress, toward
				stated treatment objectives;
(e)
				medication orders from the prescribing physician and documentation of the
				administration of all medications;
(f) signed orders by a licensed mental health
				professional for any restrictions of rights; and, privileges accorded clients
				of the crisis response facility including the reasons for the restriction;
				and
(g) a discharge summary which
				must be completed within one week of the date of discharge.
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 37.106.1987 - OUTPATIENT CRISIS RESPONSE FACILITY: CLIENT ASSESSMENTS

Current through Register Vol. 13, July 5, 2024
(1) Each outpatient crisis response facility
				shall employ or contract with licensed mental health professionals to conduct
				clinical intake assessments which may be abbreviated assessments focusing on
				the crisis issues and safety.
(a) Abbreviated
				intake assessments must be conducted by a licensed mental health professional
				trained in clinical assessments including chemical dependency screening. The
				clinical intake assessment must include sufficient detail to individualize
				crisis plan goals and objectives.
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 37.106.1989 - OUTPATIENT CRISIS RESPONSE FACILITY: CLIENT DISCHARGE

Current through Register Vol. 13, July 5, 2024
(1) Each outpatient crisis response facility
				shall prepare a discharge summary for each client no longer receiving services.
				The discharge summary must include:
(a) the
				reason for discharge;
(b) a summary
				of the services provided by the crisis response facility including
				recommendations for aftercare services and referrals to other services, if
				applicable;
(c) an evaluation of
				the client's progress as measured by the treatment plan and the impact of the
				services provided by the facility; and
(d) the signature of the staff member who
				prepared the report and the date of preparation.
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 37.106.1990 - OUTPATIENT CRISIS RESPONSE FACILITY: MANAGEMENT OF INAPPROPRIATE CLIENT BEHAVIOR

Current through Register Vol. 13, July 5, 2024
(1) The facility
				must develop and implement written policies and procedures that govern the
				management of inappropriate client behavior only as allowed in
				42 CFR
				482.13 (f) (1) through (6).
(2) The department adopts and incorporates by
				reference
				42 CFR
				482.13 (f) (1) through (6) (July 2, 1999),
				which contains standards for use of seclusion and restraint for behavioral
				management.
(3) The policies and
				procedures must:
(a) specify all
				facility-approved interventions to manage inappropriate client behavior and
				designate these interventions on a hierarchy to be implemented, ranging from
				most positive or least intrusive, to least positive or most
				intrusive;
(b) ensure, prior to the
				use of more restrictive techniques, that the client's record documents that
				programs incorporating the use of less intrusive or more positive techniques
				have been tried systematically and demonstrated to be ineffective;
				and
(c) address the following:
(i) the use of observation and seclusion
				rooms;
(ii) the use of time-out
				procedures;
(iii) the use of
				appropriate medication to manage inappropriate behavior;
(iv) the staff members who may authorize the
				use of specified interventions; and
(v) a mechanism for monitoring and
				controlling the use of such interventions.
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 37.106.1993 - OUTPATIENT CRISIS RESPONSE FACILITY: PERSONNEL RECORDS

Current through Register Vol. 13, July 5, 2024
(1) For each employee or contracted
				individual, the outpatient crisis response facility shall maintain the
				following information on file:
(a) a current
				job description;
(b) if a licensed
				mental health professional, documentation of current licensure and
				certification; and
(c) dated
				documentation of the individual's involvement in orientation, training, and
				continuing education activities.
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 37.106.1994 - OUTPATIENT CRISIS RESPONSE FACILITY: QUALITY ASSESSMENT

Current through Register Vol. 13, July 5, 2024
(1) Each outpatient crisis response facility
				shall implement and maintain an active quality assessment program using
				information collected to make improvements in the facility's policies,
				procedures and services. At a minimum, the program must include procedures for:
(a) conducting client satisfaction surveys,
				at least annually;
(b) maintaining
				records on the occurrence, duration, and frequency of seclusion and physical
				restraints used; and
(c) reviewing,
				on an ongoing basis, incident reports, grievances, complaints, medication
				errors, and the use of seclusion and/or physical restraint with special
				attention given to identifying patterns and making necessary changes in how
				services are provided.
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 37.106.1995 - OUTPATIENT CRISIS RESPONSE FACILITY: COMPLIANCE WITH BUILDING AND FIRE CODES, FIRE EXTINGUISHERS, SMOKE DETECTORS, AND MAINTENANCE

Current through Register Vol. 13, July 5, 2024
(1) Each outpatient crisis response facility
				shall ensure that its facilities, buildings, and homes:
(a) meet all applicable state and local
				building and fire codes. The facility must be annually inspected for compliance
				with fire codes by the state fire marshal or the marshal's designee, and the
				facility shall maintain a record of such inspection for at least one year
				following the date of the inspection;
(b) have a workable portable fire
				extinguisher on each floor, with a minimum rating of 2A10BC. Extinguishers must
				be readily accessible at all times;
(c) have a properly maintained and monthly
				tested smoke detector, approved by a recognized testing laboratory, on each
				floor of the facility; and
(d) have
				building exits which must be unobstructed and clearly marked.
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 37.106.1996 - OUTPATIENT CRISIS RESPONSE FACILITY: PHYSICAL ENVIRONMENT

Current through Register Vol. 13, July 5, 2024
(1) Each outpatient crisis response facility
				must ensure that no more than four clients reside in a single treatment room.
				Each treatment room must contain at least 80 square feet per client, exclusive
				of toilet rooms, closets, lockers, wardrobes, alcoves, or vestibules. Each
				center must further provide:
(a) one toilet
				for every four clients;
(b) a hand
				washing sink in each toilet room;
(c) one bathing facility for every 12
				clients; and
(d) showers and tubs
				with nonslip surfaces and handicap grab bars capable of supporting a sustained
				weight of 250 lbs.
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 37.106.1997 - OUTPATIENT CRISIS RESPONSE FACILITY: EMERGENCY PROCEDURES

Current through Register Vol. 13, July 5, 2024
(1) Each outpatient crisis response facility
				shall develop a written plan for emergency procedures. At a minimum, the plan
				must include:
(a) emergency evacuation
				procedures to be followed in the case of fire or other emergency;
(b) procedures for contacting emergency
				service responders; and
(c) the
				names and phone numbers for contacting other crisis response facility staff in
				emergency situations.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2001 - MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES

Current through Register Vol. 13, July 5, 2024
(1) In addition to the requirements
				established in this subchapter, each mental health center providing foster care
				for mentally ill adults shall utilize only foster care providers licensed by
				the department pursuant to ARM Title 37, chapter 100, subchapter 1.
Sec.
					 50-5-103,
					 MCA; IMP, Sec.
					 50-5-103
					 and
					 50-5-204,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2004 - MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, POLICY AND PROCEDURES

Current through Register Vol. 13, July 5, 2024
(1) Each mental
				health center that has a foster care program endorsement shall have policy and
				procedures in place to make initial and periodic assessment of the foster care
				provider's ability to meet the following criteria:
(a) ability to provide necessary services and
				supports to the client; and
(b)
				ability to support the client's rights as outlined in
				53-21-142,
				MCA.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2005 - MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, RECORDS

Current through Register Vol. 13, July 5, 2024
(1) For each foster care provider, the mental
				health center shall maintain the following information on file:
(a) initial and annual assessments of the
				provider's ability to provide necessary services and supports to the client and
				ability to support the client's rights as outlined in
				53-21-142,
				MCA; and
(b) documentation of the
				orientation session prior to entering into a client placement agreement, and
				annually thereafter.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2006 - MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, STAFF SUPERVISION AND TRAINING

Current through Register Vol. 13, July 5, 2024
(1) A mental health
				center providing foster care shall employ a program supervisor who is
				experienced in providing services to individuals with mental illnesses. The
				program supervisor shall supervise all foster care specialists and ensure the
				program complies with the requirements of this subchapter. The program
				supervisor may perform the duties of an adult foster care specialist if the
				mental health center has not more than 10 adult foster care clients.
(2) A mental health center providing foster
				care shall train the program supervisor and adult foster care specialists in
				the therapeutic de-escalation of crisis situations. The training must include
				the use of physical and non-physical methods of managing clients and must be
				updated, at least annually.
(3) The
				mental health center shall provide periodic training to reinforce and update
				the initial training outlined in this rule.
Sec.
					 50-5-103,
					 MCA; IMP, Sec.
					 50-5-103
					 and
					 50-5-204,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2011 - MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, ADULT FOSTER CARE SPECIALIST

Current through Register Vol. 13, July 5, 2024
(1) A mental health
				center providing foster care shall employ or contract with at least one adult
				foster care specialist.
(2) The
				adult foster care specialist shall have the knowledge and skills needed to
				effectively perform foster care specialist duties. Minimum qualifications for a
				foster care specialist are a bachelor's degree in a human services field with
				one year of full time experience serving people with mental illnesses.
				Individuals with other educational backgrounds who, as providers, consumers or
				advocates of mental health services have developed the necessary skills, may
				also be employed as foster care specialists. The mental health center's foster
				care specialists position description may contain equivalency
				provisions.
(3) The adult foster
				care specialist shall:
(a) implement and
				coordinate mental health services to clients;
(b) carry a case load of not more than 16
				foster care clients;
(c) meet with
				the foster care provider at least weekly in his or her home or whenever there
				is a significant change in the client's condition, to assess, at a minimum, the
				following:
(i) the provider's ability to
				continue to meet the needs of the client as determined by the treatment plan;
				and
(ii) whether supports for the
				foster care provider are adequate; and
(d) document bi-weekly summaries or sooner if
				there is a significant change in the client's condition regarding the client's
				treatment in the client's clinical record.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2015 - MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, CLIENT ADMISSION CRITERIA AND NEEDS ASSESSMENT

Current through Register Vol. 13, July 5, 2024
(1) A
				mental health center providing foster care shall establish admission criteria
				which assesses the client's needs and the appropriateness of foster care
				services to meet those needs. At a minimum, the admission criteria must require
				that a client:
(a) be 18 years of age or
				older;
(b) be unable to maintain
				the stability of their mental illness in an independent living
				situation;
(c) be diagnosed with a
				severe disabling mental illness;
(d) be medically stable;
(e) not be an immediate danger to self or
				others; and
(f) be able to take
				medications when prompted.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2016 - MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, TREATMENT PLAN

Current through Register Vol. 13, July 5, 2024
(1) A mental health
				center providing foster care shall implement a treatment plan for each client
				that:
(a) structures rehabilitation and
				treatment activities to promote increasing levels of independence;
(b) articulates a detailed crisis plan;
				and
(c) articulates arrangements
				for the client's discharge from the foster care home in the following areas:
(i) housing;
(ii) employment;
(iii) education and training;
(iv) treatment; and
(v) any other services needed for independent
				living.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2017 - MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, CLIENT PLACEMENT AGREEMENTS

Current through Register Vol. 13, July 5, 2024
(1) The mental
				health center shall enter into an individual placement agreement which sets
				forth the terms of the client's placement, the responsibilities of the foster
				care provider, the mental health center, the client, and when appropriate, the
				guardian.
(2) The placement
				agreement must be signed with copies dispersed to all parties who are a part of
				the agreement.
(3) The placement
				agreement shall be reviewed quarterly by all parties who are part of the
				agreement to determine the need for any amendments to the agreement.
Sec.
					 50-5-103,
					 MCA; IMP, Sec.
					 50-5-103
					 and
					 50-5-204,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2018 - MENTAL HEALTH CENTER: FOSTER CARE FOR ADULTS WITH MENTAL ILLNESSES, CLIENT RIGHTS AND RESPONSIBILITIES

Current through Register Vol. 13, July 5, 2024
(1) Upon
				admission a mental health center providing foster care shall provide each
				client with:
(a) a written statement of the
				client's rights which, at a minimum, include the rights found in
				53-21-142,
				MCA;
(b) a copy of the mental
				health center grievance procedure; and
(c) written rules of conduct for the foster
				care home and the consequences to the client for violating the rules.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2025 - APPLICATION OF OTHER RULES

Current through Register Vol. 13, July 5, 2024
(1) In addition
				to the requirements established in this subchapter, each mental health center
				providing a secured inpatient crisis stabilization program shall comply with
				all the requirements established in ARM
				37.106.1945 and
				37.106.1946 with the exclusion of
				ARM 37.106.1946(3)(j).
(2) To the extent that other licensure rules
				in ARM Title 37, chapter 106, subchapter 3 conflict with the terms of this
				subchapter, the terms of this subchapter will apply to secured crisis
				stabilization facilities.
50-5-103,
					 MCA; IMP,
					 50-5-201,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2026 - SCOPE OF THIS RULE

Current through Register Vol. 13, July 5, 2024
(1) This rule is
				intended to apply to all state licensed mental health centers or hospitals
				providing a secured crisis stabilization service as part of the crisis service
				continuum.
50-5-103,
					 MCA; IMP,
					 50-5-201,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2027 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
In addition to the definitions in
				  50-5-101,
				  MCA, the following definitions apply to this subchapter:
(1) "Crisis plan" means an initial, brief,
				individualized plan that:
(a) lists client
				problems identified by the secured crisis stabilization facility's mental
				health crisis assessment;
(b) lists
				the individual's strengths and resources;
(c) addresses cultural
				considerations;
(d) identifies
				support network options; and
(e)
				identifies referral and transition activities that will occur at
				discharge.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2031 - CONSTRUCTION REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) Prior to
				construction, floor plans for the secured in-patient crisis stabilization
				facility must be submitted to the Licensure Bureau of the Department of Public
				Health and Human Services for review, comment, and approval.
(a) Prior to occupancy, the facility shall
				undergo an onsite inspection and receive the written approval of all
				authorities having jurisdiction.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2032 - PATIENT TOILETS AND BATHING

Current through Register Vol. 13, July 5, 2024
(1) There
				will be at least one toilet available for every four patients in the
				facility.
(2) There will be at
				least one bathing unit for every six patients in the facility. A shower or tub
				is not required if the facility utilizes a central bathing unit for every six
				patients.
(3) All doors to toilet
				rooms or bathing units must swing out or slide into the wall and shall be
				unlockable from the outside.
(4)
				Toilet rooms and bathing facilities may be under key control by
				staff.
50-5-103,
					 MCA; IMP,
					 50-5-201,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2033 - SPECIAL LOCKING ARRANGEMENTS

Current through Register Vol. 13, July 5, 2024
(1) The
				facility must follow the provisions of the 2000 Edition of the NFPA 101, Life
				Safety Code, (LSC). A copy of this publication can be obtained from the
				Department of Public Health and Human Services, Quality Assurance Division,
				Licensure Bureau, 2401 Colonial Drive, P.O. Box 202953, Helena MT
				59620-2953.
(2) The 2000 Edition of
				the NFPA 101, Life Safety Code, (LSC), has the following requirements for
				special locking arrangements for a secured SCSF unit. LSC 5- 2.1.6.1 states:
(a) In buildings protected throughout by an
				approved supervised automatic fire detection system or approved supervised
				automatic sprinkler system and when permitted by chapters 8 through 30, doors
				in low or ordinary hazard areas, as defined by LSC 4-2.2, may be equipped with
				approved, listed, locking devices which shall:
(i) unlock upon actuation of an approved
				supervised automatic fire detection system or approved supervised automatic
				sprinkler system installed in accordance with LSC 7-6 or 7-7; and
(ii) unlock upon loss of power controlling
				the lock or locking mechanism; and
(iii) initiate an irreversible process which
				will release the lock within 15 seconds whenever a force of not more than 15
				pounds (67N) is continuously applied, for a period of not more than three
				seconds to the release device required in LSC 5- 2.1.5.3. Relocking of such
				doors shall be by manual means only. Operation of the release device shall
				activate a signal in the vicinity of the door for assuring those attempting to
				exit that the system is functional. Exception to this subsection: The authority
				having jurisdiction may approve a delay not to exceed 30 seconds provided that
				reasonable life safety is assured pursuant to LSC 5- 2.1.6.2. A sign shall be
				provided on the door adjacent to the release device which reads:
PUSH UNTIL ALARM SOUNDS
DOOR CAN BE OPENED IN 15 SECONDS
(A) Sign
				letters shall be at least one inch (2.5cm) high and one eighth inch (0.3cm)
				wide stroke.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2034 - SECLUSION AND RESTRAINT

Current through Register Vol. 13, July 5, 2024
(1) A SCSF must be
				capable of providing restraint or seclusion and must ensure that the restraint
				or seclusion is performed in compliance with
				42 CFR
				482.13 (f)(1) through (7). The department
				adopts and incorporates by reference
				42 CFR
				482.13 (f)(1) through (7) (July 2, 1999),
				which contains standards for use of seclusion and restraint for behavioral
				management.
(2) Restraint and
				seclusion must be performed in a manner that is safe, proportionate, and
				appropriate to the severity of the behavior, the patient's size, gender,
				physical, medical, and psychiatric condition and personal history.
(3) Seclusion or restraint may only be used
				in emergency situations needed to ensure the physical safety of the individual
				patient, other patients, or staff of the facility and when less restrictive
				measures have been found to be ineffective to protect the resident or others
				from harm.
(4) Seclusion and
				restraint procedures must be implemented in the least restrictive manner
				possible in accordance with a written modification to the patient's health
				care/treatment plan and discontinued when the behaviors that necessitated the
				restraint or seclusion are no longer in evidence.
(5) "Whenever needed" or "prescribed as
				needed" standing orders for use of seclusion or restraint are
				prohibited.
(6) A physician or
				other authorized health care provider must authorize use of the restraint or
				seclusion within one hour of initiating the restraint or seclusion. Each
				original order and renewal order is limited to four hours.
(7) Each order of restraint or seclusion is
				limited in length of time to a total of 24 hours.
(8) A SCSF will have a minimum one
				"comfort/safe" room for use for patient seclusion as prescribed by the
				facility's policy and procedures, and in accordance with applicable state and
				federal standards.
50-5-103,
					 MCA; IMP,
					 50-5-103,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2038 - ADMISSIONS PROCEDURES

Current through Register Vol. 13, July 5, 2024
(1) The facility
				will develop and implement a written policy outlining the admission criteria
				for placing a client into the secured service.
50-5-103,
					 MCA; IMP,
					 50-5-201,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2039 - DISCHARGE PROCEDURES

Current through Register Vol. 13, July 5, 2024
(1) The facility
				shall develop and implement discharge and transfer criteria for discharging a
				client from the secured setting. At the end of the detention the facility must:
(a) discharge the patient;
(b) refer the patient to a licensed
				nonsecured inpatient stabilization program;
(c) refer the patient to outpatient
				treatment; or
(d) transfer the
				client to an appropriate level of acute in-patient treatment.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2042 - STAFF QUALIFICATIONS AND ORGANIZATIONAL STRUCTURE

Current through Register Vol. 13, July 5, 2024
(1) Each SCSF shall employ or contract with a
				site based administrator who has daily overall management responsibility for
				the operation of the SCSF. The administrator of the mental health center or
				hospital if they are site based to the secured crisis stabilization or, if the
				SCSF is part of a hospital per ARM
				37.106.2027(2) 
				may assume this responsibility.
(2)
				Each SCSF facility shall employ or contract with a program supervisor
				knowledgeable about the service and support needs of individuals with
				co-occurring mental illness and intoxication/addiction disorders who may be
				experiencing a crisis. The program supervisor must be site based.
(3) Each SCSF shall employ or contract with a
				licensed health care professional as defined in
				50-5-101(34),
				MCA, for all hours of operation. The licensed health care professional may be
				the program supervisor.
50-5-103,
					 MCA; IMP,
					 50-5-103,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.106 - HEALTH CARE FACILITIES › Subchapter 37.106.20 - Mental Health Center: Foster Care for Adults With Mental Illnesses › Rule 37.106.2046 - SECURED CRISIS STABILIZATION FACILITY: CLIENT ASSESSMENTS

Current through Register Vol. 13, July 5, 2024
(1) Each SCSF shall employ or contract with
				licensed mental health professionals to conduct clinical intake assessments
				which may be abbreviated assessments focusing on the crisis issues and safety.
(a) Abbreviated intake assessments must be
				conducted by a licensed mental health professional trained in clinical
				assessments including chemical dependency screening. The clinical intake
				assessment must include sufficient detail to individualize crisis plan goals
				and objectives.