Virginia Administrative Code › Title 12 - HEALTH › Agency 30 - DEPARTMENT OF MEDICAL ASSISTANCE SERVICES › Chapter 122 - COMMUNITY WAIVER SRVICES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES › Section 12VAC30-122-350 - Crisis support service

Current through Register Vol. 40, No. 24, July 15, 2024
A.
				Service description. Crisis support service is designed for individuals
				experiencing circumstances such as (i) marked reduction in psychiatric,
				adaptive, or behavioral functioning; (ii) an increase in emotional distress;
				(iii) needing continuous intervention to maintain stability; or (iv) causing
				harm to themselves or others. Crisis support service means intensive supports
				by trained and, where applicable, licensed staff in crisis prevention, crisis
				intervention, and crisis stabilization for an individual who is experiencing an
				episodic behavioral or psychiatric event in the community that has the
				potential to jeopardize the current community living situation. This service is
				designed to prevent the individual from experiencing an episodic crisis that
				has the potential to jeopardize his current community living situation, to
				intervene in such a crisis, or to stabilize the individual after the crisis.
				This service shall prevent escalation of a crisis, maintain safety, stabilize
				the individual, and strengthen the current living situation so that the
				individual can be supported in the community beyond the crisis period. Crisis
				support service shall be covered in the FIS, CL, and BI waivers.
B. Criteria and allowable activities. Crisis
				support service may include as appropriate and necessary:
1. Crisis prevention services, which provide
				assessment of an individual's medical, cognitive, and behavioral status as well
				as predictors of self-injurious, disruptive, or destructive behaviors, with
				initiation of positive behavior supports to resolve and prevent future
				occurrence of crisis situations. Crisis prevention services shall also include
				training for family/caregivers to avert further crises and to maintain the
				individual's typical routine to the maximum extent possible. Crisis prevention
				services shall also encompass supporting the family and individual through team
				meetings, revising the behavior plan or guidelines, and other activities as
				changes to the behavior support plan are implemented and residual concerns from
				the crisis situation are addressed.
2. Crisis intervention services, which shall
				be used during a crisis to prevent further escalation of the situation and to
				maintain the immediate personal safety of those involved. Crisis intervention
				services shall be a short-term service providing highly structured intervention
				that can include, for example, temporary changes to the person's residence,
				changes to the person's daily routine, and emergency referral to other care
				providers. Crisis intervention staff shall model verbal deescalation techniques
				including active listening, reflective listening, validation, and suggestions
				for immediate changes to the situation.
3. Crisis stabilization, which entails
				gaining a full understanding of the factors that contributed to the crisis once
				the immediate threat has resolved and there is no longer an immediate threat to
				the health and safety of the individual or others. Crisis stabilization
				services shall be geared toward gaining a full understanding of all of the
				factors that precipitated the crisis and may have maintained it until trained
				staff from outside the immediate situation arrived. These services result in
				the development of new plans that may include environmental modifications,
				interventions to enhance communication skills, or changes to the individual's
				daily routine or structure. Crisis stabilization staff shall train
				family/caregivers and other persons significant to the individual in techniques
				and interventions to avert future crises.