10 Colo. Code Regs. § 2505-10-8.7532

Current through Register Vol. 47, No. 24, December 25, 2024

Section 10 CCR 2505-10-8.7532 - Mental Health Transitional Living Homes

8.7532.AMental Health Transitional Living Homes Definitions

1. Mental Health Transitional Living Home (MHTL) Certification means documentation from the Colorado Department of Public Health and Environment (CDPHE) recommending certification to the Department after the Provider Agency has met all licensing and regulatory requirements.

2. Protective Oversight is as defined at Section 8.7506.B.2.

8.7532.BMental Health Transitional Living Homes Member Eligibility

1. Mental Health Transitional Living Homes (MHTL) service is a covered benefit available to Members who meet the following requirements:

a. Members are determined functionally eligible for Community Mental Health Supports (CMHS) waiver by a Case Management Agency;

b. Members are enrolled in the HCBS Community Mental Health Supports Waiver; and

c. Members require the specialized services provided under the Mental Health Transitional Living Homes as determined by assessed need.

8.7532.CMental Health Transitional Living Homes Inclusions

1. The Mental Health Transitional Living service assists the Member to reside in the most integrated setting appropriate to their needs. Staff shall be specifically trained to support Members with a severe and persistent mental illness and who may be experiencing a mental health crisis or episode.

2. This residential service includes the following:

a. Protective Oversight and supervision;

b. Assistance with administering medication and medication management;

c. Assistance with community participation and support in accessing the community;

d. Assistance with recreational and social activities;

e. Housing planning and navigation services as appropriate for Members experiencing homelessness/at risk for homelessness;

f. Life skills training; and

g. Activities of Daily Living support as needed.

3. Room and board are not benefits of Mental Health Transitional Living services. Members are responsible for room and board in an amount not to exceed the Department's established rate.

4. Additional services that are available as a State Plan benefit or other HCBS Community Mental Health Supports Waiver service shall not be provided under the Mental Health Transitional Living service.

5. Member engagement opportunities shall be provided by the Mental Health Transitional Living home, as outlined in 6 C.C.R. 1011-1, Chapter VII, Section 12.19-26.

8.7532.DMental Health Transitional Living Homes Member Rights

1. Mental Health Transitional Living Homes shall inform Members of their rights, according to 6 C.C.R. 1011-1:7-13 and Section 8.7001. Any modification of those rights shall be in accordance with Section 8.7001.B.4. Pursuant to 6 C.C.R. 1011-1:7-13, Mental Health Transitional Living Homes shall ensure the policy on resident rights is posted in a visible location so that it is always available to Members and visitors.

2. Mental Health Transitional Living Homes shall inform Members of all policies specific to the Mental Health Transitional Living setting upon admission to the setting, and when changes to policies are made, rules and/or policies shall apply consistently to the administrator, staff, volunteers, and Members residing in the home and their family or friends who visit. Member acknowledgement of rules and policies must be documented in the service plan or a resident agreement.

3. If requested by the Member, the Mental Health Transitional Living home shall provide bedroom furnishings, including but not limited to a bed, bed and bath linens, a lamp, chair and dresser and a way to secure personal possessions.

8.7532.EMental Health Transitional Living Provider Agency Eligibility

1. To be certified as a Mental Health Transitional Living Provider Agency, the entity seeking certification must be licensed by CDPHE as an Assisted Living Residence (ALR) pursuant to 6 C.C.R. 1011-1, Ch. VII.

2. Applicants for Mental Health Transitional Living Certification shall meet the applicable standards of the rules for building, fire, and life safety code enforcement as adopted by the Colorado Division of Fire Prevention and Control.

3. Mental Health Transitional Living Provider Agencies must receive from CDPHE a recommendation for Mental Health Transitional Living Certification.

4. No recommendation for Mental Health Transitional Living Certification shall be issued if the owner, applicant, or administrator of the Mental Health Transitional Living home has been convicted of a felony or misdemeanor involving a crime of moral turpitude or that involves conduct that the Department determines could pose a risk to the health, safety, or welfare of the members residing in the Mental Health Transitional Living home.

5. Provider Agencies must be certified and enrolled with the Department prior to rendering services.

6. All Mental Health Transitional Living Homes shall be operated by or under contract with the Department of Human Services or Behavioral Health Administration.

8.7532.FMental Health Transitional Living Provider Agency Roles and Responsibilities

1. Service Requirements a. The Mental Health Transitional Living Provider Agencies shall provide Protective Oversight and Mental Health Transitional Living services to Members every day of the year, 24 hours per day.

b. Mental Health Transitional Living Provider Agencies shall maintain and follow written policies and procedures for the administration of medication in accordance with 6 C.C.R. 1011-1, Chapters VII and XXIV.

c. Mental Health Transitional Living Provider Agencies shall not discontinue services to a Member unless documented efforts have been ineffective to resolve the conflict leading to the discontinuance of services in accordance with 6 C.C.R. 1011-1, Chapter VII, Section 11.

d. The Provider Agency shall encourage and assist Members' participation in engagement opportunities and activities within the Mental Health Transitional Living home community and the wider community, when appropriate.

e. The Provider Agency shall develop emergency policies that address, at a minimum, a plan that ensures the availability of, or access to, emergency power for essential functions and all member-required medical devices or auxiliary aids.

2. Provider Agency Service Plan

a. The service plan must outline the goals, choices, preferences, and needs of the Member. Medical information must also be included, specifically:

i. If the Member is taking any medications and how they are administered, with reference to the Medication Administration Record (MAR);

ii. Supports needed with Activities of Daily Living;

iii. Special dietary needs, if any; and

iv. Incorporation of any documented physician orders.

b. Even if recommended by the Member's physician or other practitioner, staff interventions that interfere with the Member's choice of food, freedom to determine their own activities, or exercise of any other rights are Rights Modifications that must comply with Section 8.7001.B.

c. The service plan must contain evidence that the Member and/or their Guardian or other Legally Authorized Representative has had the opportunity to participate in the development of the plan, as evidenced by the Member's and/or their Guardian's or other Legally Authorized Representative's signature on the plan. The signature may be physical or digital. If the Member is unable to sign the service plan because of a medical condition, any mark the Member is capable of making shall be accepted in lieu of a signature. If the Member is not capable of making a mark or performing a digital signature, the physical or digital signature of a Guardian or other Legally Authorized Representative shall be accepted.

3. Environmental Standards

a. The Mental Health Transitional Living Provider Agency shall adhere to regulations at 6 C.C.R. 1011-1, Ch. VII, Sections 15,16, 17, and 19.

4. Staffing

a. The Mental Health Transitional Living home must have appropriate staffing levels to meet the individual acuity, needs and level of assistance required of the Members in the setting.

b. In addition to the trainings outlined in 6 C.C.R. 1011-1, Ch. VII, Section 7, staff must be trained in the following topics prior to working independently with Members:

i. Mental Health First Aid.

ii. Question, Persuade, Refer (QPR).

iii. Suicide and Homicide Risk Screenings.

iv. Trauma Informed Care Methodologies and Techniques.

v. Symptom Management.

vi. Behavior Management.

vii. Motivational Interviewing.

viii. Transitional Planning.

ix. Community Reinforcement and Family Training.

8.7532.GMental Health Transitional Living Homes Reimbursement

1. Mental Health Transitional Living services are reimbursed on a per diem basis, as determined by the Department.

2. Additional Charges

a. Provider Agencies shall not bill supplemental charges to any Members, except for amounts designated as copayments by the Department.

10 CCR 2505-10-8.7532

47 CR 03, February 10, 2024, effective 3/16/2024

47 CR 21, November 10, 2024, effective 11/30/2024