La. Admin. Code tit. 48 § III-511

Current through Register Vol. 50, No. 9, September 20, 2024

Section III-511 - Program Requirements

A. General

1. Community mental health centers shall provide for a comprehensive range of mental health services offered in a manner so that they are accessible to persons in need, and so that any person eligible for one element of services is eligible for all other elements of service, and that continuity of care is assured. Outpatient services and consultation and education services shall be offered directly by the center. Other services may be made available through appropriate written affiliation agreements provided that the affiliate meets all requirements of these standards and complies with all pertinent local, state and federal laws and regulations.

2. Community mental health clinics may provide a more limited range of mental health services including at least outpatient treatment. However, if services mandatory for a center are not provided directly by the clinic, they shall be made available to residents of the area served by the clinic through the parent center. An appropriate current written plan shall be developed to assure the availability of such services through the parent center to residents of the area served by the clinic.

B. Elements of Service. Community mental health centers shall provide the following essential elements of service:

1. Inpatient Services

a. The inpatient facility shall be licensed under appropriate laws and regulations of the state of Louisiana.

2. Outpatient Services

a. A variety of outpatient services including both group and individual treatment shall be made available, based on an assessment of client demand and community need. In every case, outpatient services offered shall be planned based upon the individual needs of the patient derived from the assessment and documented in the treatment plan.

b. Outpatient services shall be promptly available during normal working hours. Clinics should additionally provide such services during evening hours for persons who are not able to utilize these services during normal working hours.

3. Partial Hospitalization Services

a. Partial hospitalization programs shall be utilized for one or more of the following purposes:

i. as an alternative to inpatient care;

ii. as a transitional program for rehabilitation of long-term patients;

iii. as a maintenance program for long-term patients;

iv. as an extension of outpatient services;

v. as a diagnostic and observational procedure.

b. Purpose of the partial hospitalization program shall be clearly stated in writing, and factors related to the program such as hours of operation, physical plant, staffing pattern, and program shall be written and based upon the stated purpose.

c. There shall be at least one professionally qualified clinical staff member on duty in the partial hospitalization program during all hours that it is in operation.

4. Emergency Services

a. The psychiatric facility shall have a written plan delineating the ways in which emergency services are provided for both physical and psychiatric emergencies. The emergency service may be provided by the facility or through clearly defined arrangements with another facility. When emergency services are provided by the facility itself, it shall be well organized, properly directed an integrated with the other services.

b. When emergency services are provided by an outside facility, the center shall delineate in its written plan the nature of emergency services available and the arrangements for referral or transfer to another facility. The written plan shall be available to all staff and shall clearly specify:

i. the staff of the center who are available and authorized to provide necessary emergency psychiatric or physical evaluations and initial treatment;

ii. the staff of the center who are authorized to arrange for referral or transfer to another facility when it is necessary;

iii. arrangements for exchange of records when important for the care of the patient;

iv. the location of the outside facility and appropriate personnel to be contacted;

v. the method of communication the between two facilities;

vi. arrangements to ensure that a patient requiring both medical and psychiatric care who is transferred to a non-psychiatric service or facility will receive further evaluation and/or treatment of his psychiatric problem;

vii. details regarding arrangements for transportation, when necessary, from the psychiatric facility to the facility providing emergency services;

viii. the policy for referral back to the referring facility of those patients needing continued psychiatric care after emergency treatment.

c. The written plan shall include policies regarding the notification of the patient's family of emergencies which arise and the arrangements which have been made for referral or transfer to another facility.

d. The patients and families being served by the facility shall be informed of the plan for emergency services. All patients and families who are receiving partial day or outpatient services should be informed of whom to contact or where to go for emergency services when the facility is closed.

5. Consultation and Education

a. In order to enhance the continuity of the patient's life within the community, the center shall maintain positive relationships and liaison with general community resources, and shall enlist the support of these resources to participate in community activities, as indicated. The facility shall participate in a network of other community services and shall be responsive to community needs. In serving patients and their families, the facility shall collaborate with other community resources. There shall be a well organized plan for the facility's involvement with the community.

b. The center shall assume responsibility for making mental health information available to the public, in conjunction with other health and social agencies. The center shall work in conjunction with other agencies to provide information about a wide variety of mental health topics, such as new treatment methods and services available, factors that help prevent mental illness, better understanding of social problems contributing to emotional stress, and preventive services that are available.

c. The center shall engage in preventive approaches to mental health problems in a manner appropriate to its functions and its own stated goals. The facility should be involved in prevention in collaboration with schools, clinics, hospitals, welfare services and other institutions and agencies in the total community mental health program. In this regard the facility should cooperate with local citizens groups and organizations, as well as consumer representatives.

d. The center shall offer professional education and consultation to others. This includes other members of the community, whether medical, educational, legal, law enforcement, clerical, social or welfare personnel, who are working with persons who have psychiatric disorders. The aim of this educational consultation program should be geared toward prevention and toward enhancing the ability of other personnel to understand and help those suffering from mental illness. Where such preventive, research, consultation, or education programs are provided for other agencies or individuals within the community, there shall be appropriate records, and sufficient time and appropriately qualified staff shall be available to ensure quality and effective services.

e. The center shall have an ongoing role relating to the total community in providing consultation and planning for the total life experiences of persons in its care, and shall coordinate its planning with that of other agencies with whom these persons and their families are involved.

6. Community mental health centers should additionally provide the following specialized services:

a. a program of specialized services for the mental health of children, including a full range of diagnostic, treatment, liaison, and follow-up services;

b. a program of specialized services for the mental health of the elderly, including a full range of diagnostic, treatment, liaison, and follow-up services;

c. a program of assistance to courts, coroners, and other agencies for screening residents of the catchment area who are being considered for referral for inpatient psychiatric treatment, to determine if inpatient treatment is indicated, and to provide for alternate treatment through the center when appropriate;

d. a program of follow-up care for residents of the catchment area who have been discharged from mental health facilities;

e. a program of transitional care including halfway houses, foster care, and other forms of community based residential care for mentally ill individuals who are residents of the catchment area and who have been discharged from a mental health facility or would, without such services, require inpatient care;

f. unless it is determined that there is not sufficient need, or that need is being met otherwise, the center should provide programs for:

i. the prevention and treatment of alcoholism and alcohol abuse and for the rehabilitation and treatment of alcohol abusers and alcoholics;

ii. the prevention and treatment of drug addiction and abuse and for the rehabilitation of drug addicts, drug abusers, and other persons with drug dependency problems.

La. Admin. Code tit. 48, § III-511

Promulgated by the Department of Health and Human Resources, Office of Mental Health, LR 13:246 (April 1987).

AUTHORITY NOTE: Promulgated in accordance with PL 94 :63, the Community Mental Health Centers' Act of 1975 and R.S.1950, Title 28, §203.