Section 440IAC9-2-7. Residential services for adults with psychiatric disorders

   (a) Managed care providers and community mental health centers shall provide residential services according to the standards set out in this section. Managed care providers and community mental health centers shall ensure that their subcontractors who provide residential services also meet the same standards.

  (b) Residential services for adults with psychiatric disorders can take place in a variety of settings, as appropriate for the individual consumer.

  (c) Residential services that are a part of the continuum of care must be provided in a variety of settings, including at least two (2) of the following types of settings:

(1) Supervised group living facility.

(2) Transitional residential facility.

(3) Subacute stabilization facility.

(4) Semi-independent living facility.

(5) Alternative family for adults program.

  (d) Residential services for adults with psychiatric disorders must be based on a written, cohesive, and clearly stated philosophy and treatment orientation and must include the following standards:

(1) There must be evidence that the philosophy is based on literature, research, and proven practice models.

(2) The services must be client centered.

(3) The services must consider client preferences and choices.

(4) There must be a stated commitment to quality services.

(5) The residents must have a safe and drug free environment.

(6) The individual environment must be as homelike as possible.

  (e) The services must provide flexible alternatives with a wide variety of levels of supervision, support, and treatment as follows:

(1) The treatment services must be carried out in residences that meet all life safety requirements and are licensed or certified as appropriate.

(2) Service flexibility must allow movement toward the least restrictive environment but allow increases in intensity during relapses or cycles of relapse.

(3) The services must provide the ability to maintain residents at any level of supervision and support as required by the consumer's need. If a consumer's need exceeds the typical length of stay, services may not be terminated without just cause.

(4) The services must provide continuous or reasonably incremental steps between levels.

(5) A consumer can graduate from residential services, but cannot be terminated because of a need for more supervision, care, or direction without the agency continuing to assertively provide adequate, safe, and continuing treatment unless the resident is transferred to another entity with continuing treatment provided to the resident by that entity.

  (f) Residential services shall include specific functions that shall be made available to consumers based upon the individual treatment plan. These functions include the following:

(1) Provision of transportation or access to public transportation in accordance with the treatment plan.

(2) A treatment plan partially based on a functional assessment of each resident's daily living, socialization, and coping skills that is based on structured evaluation and observation of behavior.

(3) Provision of services focused on assisting a resident's move to an independent setting.

(4) Respite residential services, a very short term residential care (less than two (2) weeks), to provide either relief for a caregiver or transition during a stressful situation.

(5) Crisis services, including more intensive services within twenty-four (24) hours after problem identification.

  (g) Residents, as determined by their individual treatment plan, must receive a combination of the following services:

(1) Day treatment, that may include the following:

(A) Intensive outpatient.

(B) Social, recreational, and support activities.

(C) Other models of intervention.

(2) Habilitation and rehabilitation services that may include the following:

(A) Daily living skills development.

(B) Parenting skills development.

(C) Social and recreational activities.

(D) Public involvement and education.

(E) Community reintegration.

(3) Vocational services that may include the following:

(A) Supported employment.

(B) Volunteering.

(C) Vocational rehabilitation services.

(D) Competitive employment.

(E) Job training.

(4) Appropriate educational services must be available in as normal a setting as possible.

(5) Mental health treatment, that may include the following:

(A) Group therapy.

(B) Individual counseling or psychotherapy.

(C) Medication therapy.

  (h) Family involvement must be offered to the resident as part of the service unless it is refused by the resident as documented annually in the treatment plan.

  (i) If the resident agrees to family participation and signs a release of information, the following requirements apply:

(1) The program shall solicit and consider input from the family or legal representative in the diagnosis and treatment planning process.

(2) Families or legal representatives shall be contacted when admitting residents and moving them between residences within the total service.

(3) Families or legal representatives shall be contacted quarterly regarding the resident's progress and situation.

(4) Families shall be encouraged to use appropriate family support services.

(Division of Mental Health and Addiction; 440 IAC 9-2-7; filed Jul 8, 2002, 1:58 p.m.: 25 IR 3762; readopted filed Apr 7, 2008, 3:40 p.m.: 20080507-IR-440070745RFA; readopted filed Aug 11, 2014, 11:21 a.m.: 20140910-IR-440140240RFA)