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Virginia Regulatory Town Hall
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Department of Medical Assistance Services
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Board of Medical Assistance Services
chapter
Amount, Duration, and Scope of Medical and Remedial Care and Services [12 VAC 30 ‑ 50]
Action Mental Health Skill-building Services
Stage Proposed
Comment Period Ends 10/23/2015
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9/21/15  11:29 am
Commenter: Heather Rupe, Co-Chair, VACSB Quality Leadership Committee

Crisis Intervention and Stabilization Authorization Language Consistency
 

Proposed Language:

Page 12 of 25

5. Crisis intervention shall provide immediate mental health care, available 24 hours a day, seven days per week, to assist individuals who are experiencing acute psychiatric dysfunction requiring immediate clinical attention. This service's objectives shall be to prevent exacerbation of a condition, to prevent injury to the client or others, and to provide treatment in the context of the least restrictive setting. Crisis intervention activities shall include assessing the crisis situation, providing short-term counseling designed to stabilize the individual, providing access to further immediate assessment and follow-up, and linking the individual and family with ongoing care to prevent future crises. Crisis intervention services may include office visits, home visits, preadmission screenings, telephone contacts, and other client-related activities for the prevention of institutionalization. The service-specific provider intake, as defined at 12VAC30-50-130, shall document the individual's behavior and describe how the individual meets criteria for this service.  The provision of this service to an individual shall be registered with either DMAS or the BHSA within one business day or the completion of the service-specific provider intake to avoid duplication of services and to ensure informed care coordination. Authorization shall be required for Medicaid reimbursement.

And (page 13 of 25)

7. Crisis stabilization services for nonhospitalized individuals shall provide direct mental health care to individuals experiencing an acute psychiatric crisis which may jeopardize their current community living situation. Authorization shall be required for Medicaid reimbursement. Services may be authorized for up to a 15-day period per crisis episode following a face-to-face service-specific provider intake by an LMHP, LMHP-supervisee, LMHP-resident, or LMHP-RP. Only one unit of service shall be reimbursed for this intake. The provision of this service to an individual shall be registered with either DMAS or the BHSA within one calendar day of the completion of the service-specific provider intake to avoid duplication of services and to ensure informed care coordination.  See 12VAC30-50-226 B for registration requirements.

Comment:

Per the proposed regulations, Crisis Intervention and Crisis Stabilization would require an authorization. Currently, they require a registration. Because these services are short term and meant to address time sensitive mental health needs, waiting on an authorization is not in the best interest of an individual waiting on CI services. Not consistent immediacy and need for service.  The authorization requirement is inconsistent with proposed regs, discusses authorization, but also speaks to about registration process.

Recommendation:

Continue registration requirement for Crisis Intervention and Crisis Stabilization.

CommentID: 42170