Hello, Please see several questions below:
Pg 31 - At the start of services, a LMHP, LMHP-R, LMHP-RP or LMHP-S must conduct an assessment to determine the individual’s appropriateness for the service. The assessment requirement can be met by one of the following.
Pg 32 - A psychiatric evaluation by a psychiatrist, nurse practitioner or physician assistant must be available at the time of admission into the service.
The question here is: must be available at the time of admission into the service.
Pg 32 - The Crisis Education and Prevention Plan (CEPP) meeting DBHDS requirements is required for this service and must be current. The CEPP process should be collaborative but must be directed and authorized by a LMHP, LMHP-R, LMHP-RP or LMHP-S.
Pg 33 - On the day of admission, at a minimum, RCSU providers must provide assessment, psychiatric evaluation and a nursing assessment.
Pg 34 - Services may not be provided in other locations outside of the licensed site. Services shall not be provided for the sole reason of providing temporary housing to an individual; if the individual meets other admission criteria and housing is an additional assessed need, this should be noted on the service authorization request to support continued coordination of resources for the individual.
Pg 36 - Individuals must meet all of the following criteria: 1. Documentation indicates evidence that the individual meets criteria for a primary diagnosis consistent with the most recent version of the Diagnostic and Statistical Manual 2. One of the following must be present:
a. The individual is currently under a Temporary Detention Order; b. Abrupt and substantial changes in behavior noted by severe impairment or acute decompensation in functioning related to a behavioral health problem; c. Actual or potential danger to self or others as evidenced by: a. Suicidal thoughts or behaviors and/or recent self-injurious behavior with suicidal intent; or b. Homicidal ideation; or c. Command hallucinations or delusions d. Significant loss of impulse control that threatens the safety of the individual and/or others or their ability to take care of themselves; e. Significant inability to maintain basic care for oneself and to keep oneself safe in the community in an age appropriate manner that is not associated with Dementia; f. Substance intoxication with suicidal/homicidal ideation or inability to care for self.
Pg 38 – Just a crucial observation. I see it will be complicated to justify Continued Stays. The pt has to meet ALL 8 criteria, but only 1 for admission. That said, I would wager that none of our detox pts will meet ALL of these 8 criteria for Continued Stay and will likely get denied after the initial 5 day PA.
Pg 39 - RCSU services are initially authorized through a registration process for 5 calendar days/5 units. Submission of registrations must be within 1 business day of admission.
Pg 39 - If additional activities beyond 5 calendar days/5 units are clinically required, the provider shall submit an authorization request to the FFS contractor or MCO through a continued stay service authorization request accompanied by a CEPP submitted no earlier than 24 hours before the requested start date of the continued stay.
Pg. 39 - The day of discharge is not billable.