Section 197-6-03 - SERVICES1.Capacity. The Department, subject to available resources, will maintain sufficient capacity to offer statewide in-home and out-of-home CPIS for adults with intellectual disabilities, acquired brain injuries, or Autism Spectrum Disorder. Subject to available resources, the Department shall assure that there exists capacity to conduct crisis planning, training, assessment, consultation, support, and post-crisis follow up; to provide support to prevent or respond to a crisis on-site; and to assist with securing mental health supports and appropriate professional supports when necessary, including access to a licensed mental health provider, inpatient treatment when indicated, psychiatric services, and mental health aftercare services.
2.Service LocationA. The Department will authorize, as needed, in-home or out-of-home services. B. Crisis services will be offered at a person's home, program, or workplace unless: (1) Otherwise specified in personal planning; or(2) Crisis prevention and intervention efforts to remain at home were unsuccessful.3.Transportation ServicesA. The Department will provide transportation as a crisis service only, which must be provided in a state-owned or state-leased vehicle. B. The Department will not use law enforcement entities for the transportation of persons in crisis, unless: (1) It has been specifically authorized by the person's guardian or planning team; or (2) It has been determined by law enforcement personnel to be necessary to provide for the safety of the person in crisis or others. 4.Intake ServicesA. The Department will maintain a dedicated crisis telephone intake service to receive notifications of ongoing crises and requests for crisis services ("Crisis Intake"). B. Crisis Intake shall be available 24/7 via telephone, videophone, or text message.C. Crisis Intake staff shall utilize remote crisis services in accordance with this section and connect consumers with the appropriate regional crisis services provider(s) when in-person assistance is requested or is determined by the Department to be necessary. Whether to deploy remote or in-person services will be determined by the Department on the basis of the information provided by or on behalf of the person in crisis and the availability of in-person services. D. Crisis Intake staff will either self-assign or assign the closest regional crisis services staff to meet the person in crisis on scene and make any other appropriate referrals.E. Crisis Intake will provide crisis services remotely while the person is in crisis until an in-person CPIS provider is on site or other CPIS is deployed.5.Crisis Case ManagementA. The Department shall maintain CPIS case management services to assist adults with intellectual disabilities, acquired brain injuries, or Autism Spectrum Disorder who are in crisis, when such personal crises could lead to the loss of the home, support services, or employment.B. Crisis Case Management services shall: (1) Connect the person in crisis to other community resources as needed;(2) Work in collaboration with the person's other team members; and(3) Work in collaboration with the person's community case manager.C. Crisis Case Management staff will be trained to perform other CPIS duties, if they are needed to act in that capacity. D. When the person in crisis does not have a community case manager, a crisis case manager will perform those duties during the duration of the crisis.6.PlacementsA. Crisis Stabilization Units (1) The Department will provide Crisis Stabilization Units (CSU) for adults with intellectual disabilities, acquired brain injuries, or Autism Spectrum Disorder, who are in crisis.(2) CSU will provide 24-hour observation and supervision for a qualifying person in crisis who would benefit from a short-term, structured, stabilizing setting. (3) CSU focus on initial assessment, care management, crisis case management, medication management, mobilization of resources, and achieving a safe discharge that meets the individual's needs. (4) CSU services will not exceed 3-5 days without approval from the CPIS program administrator. B. Emergency Transitional Housing (1) The Department will provide emergency transitional housing for persons in crisis at Residential Stabilization Units (RSU).(2) RSU provide 24-hour observation and supervision for qualifying persons in crisis who would benefit from a short-term, structured, stabilizing setting.(3) RSU focus on care management, medication management, mobilization of resources, and achieving a safe and individually appropriate discharge. (4) RSU services will end when other long-term services and supports that will meet the individual's needs are identified, accepted by the person, and implemented. (5) The Department will provide notice of discharge from RSU placement:(a) When the discharge is clinically indicated through achievement of goals, or(b) When a discharge is otherwise needed. (6) Discharge summary information shall be provided to the person at the time of discharge that includes: (a) Significant findings relevant to the person's recovery, including their strengths, needs, and preferences; (b) Plan of care and progress; (c) Specific instructions for ongoing care; (d) Recommendations for continued care to include community services, if indicated; and(e) Contact information for how to access community resources. 7.Post-Crisis ServicesA. The Department shall provide a post-crisis review after the person's initial contact with a crisis worker.B. The post-crisis review required pursuant to the preceding paragraph shall include: (1) Active participation, if possible, by the person;(2) Natural supports and relevant or involved providers;(3) Other appropriate members of the person's planning team;(4) Identification of the triggers of crisis for the person; and(5) Recommendations for changes in the person's environment, services and supports to help prevent or reduce crises in the future.14- 197 C.M.R. ch. 6, § 03