Section 29-4606. PROGRAM SERVICES

 

4606.1Each MCOTT Program shall have the capability to provide comprehensive treatment, rehabilitation, and support services as a self-contained service unit.

 

4606.2Each MCOTT Program shall give the highest priority to delivering individualized services outside of the MCOTT Program's office facility, in home and community settings, with an emphasis on assertive outreach to MCOTT clients with severe and persistent mental illness.

 

4606.3Each MCOTT Program shall ensure that MCOTT clients are guaranteed full access to services once they are admitted to the MCOTT Program.

 

4606.4An MCOTT Program's service delivery shall not be time-limited but shall be based on each MCOTT client's needs.

 

4606.5Each MCOTT Program shall ensure that MCOTT services are available 24-hours per day, seven days per week, including telephone and face-to-face contact, in conjunction with the EPRB Crisis Team.

 

4606.6Each MCOTT Program shall provide case management which shall involve an organized process of case coordination among the multi-disciplinary team in order to provide a full range of appropriate treatment, rehabilitation and support services to a client in a planned, coordinated, efficient and effective manner.

 

4606.7Each MCOTT Program shall provide management services to help the client cope with symptoms and disabilities as they go about daily living. These services shall include, but are not limited to:

 

(a)Ongoing assessment of the client's mental illness symptoms and the client's response to treatment;

 

(b)Symptom education to enable the client to identify his/her mental illness symptoms; and

 

(c)Individual supportive therapy and teaching of symptom management techniques to alleviate and manage symptoms that can not be treated with medication.

 

4606.8In each MCOTT Program, a psychiatrist shall provide medication management services, which shall include, but are not limited to:

 

(a)Assessment of each client's mental illness symptoms and behavior and prescription of appropriate medication;

 

(b)Monthly review and documentation of the client's mental illness symptoms as well as his/her response to prescribed medication treatment;

 

(c)Education of the client regarding his/her mental illness and the effects and side effects of medication prescribed to regulate it; and

 

(d)Monitoring, treatment and documentation of any medication side effects.

 

4606.9Each MCOTT Program shall provide clinical supervision which shall require face-to-face contact between the clinical supervisor and a staff member to review the client's clinical status and to ensure appropriate treatment and services are provided to the client by the staff member. Clinical supervision may occur during the daily organizational staff meetings and the treatment planning meetings.

 

4606.10Each MCOTT Program shall provide Activities of Daily Living services in community-based settings, which shall include individualized support, problem solving, training and supervision to assist the client to gain or utilize the skills needed to:

 

(a)Carry out personal hygiene and grooming tasks;

 

(b)Carry out household activities, including housekeeping, cooking, grocery shopping and laundry;

 

(c)Develop or improve money management skills; and

 

(d)Use available transportation.

 

4606.11Each MCOTT Program shall provide support services, which include case management, individualized support, problem solving, training and supervision to help the client obtain:

 

(a)Services to meet physical and dental health needs;

 

(b)Needed legal services;

 

(c)Financial support such as supplemental security income, social security disability insurance, general relief and money management services; and

 

(d)Living accommodations, including locating, financing and maintaining safe and normal living arrangements and enabling the client to relate to his or her landlord and neighbors in an acceptable manner.

 

4606.12Each MCOTT program shall provide social and recreational skills training services individually or in small groups to:

 

(a)Improve communication skills;

 

(b)Facilitate a appropriate interpersonal behavior; and/or

 

(c)Familiarize clients with available social and recreational opportunities and increase their use of such opportunities.

 

4606.13Each MCOTT Program shall provide substance abuse services on an as-needed basis, which shall include, but are not limited to, individual and group interventions to assist clients in:

 

(a)Identifying alcohol and drug effects and patterns;

 

(b)Recognizing the relationship between alcohol/drugs and mental illness and psychotropic medications and mental illness;

 

(c)Developing motivation for decreasing substance use;

 

(d)Developing coping skills and alternatives to minimize substance use; and

 

(e)Achieving periods of abstinence and stability.

 

4606.14Each MCOTT Program shall provide employment-related services in community-based settings to assess the effect of the MCOTT client's mental illness on employment and to develop an ongoing employment rehabilitation plan to enable the client to get and keep a job. Employment-related services include:

 

(a)Individualized initial and comprehensive evaluation, including a thorough work and academic history and on-site work assessments in community-based, MCOTT-structured jobs;

 

(b)Identification of behaviors that interfere with the client's work performance and development of interventions to alleviate the problem behaviors;

 

(c)Individual supportive counseling to enable the client to identify and cope with symptoms of mental illness that affect the client's work;

 

(d)Work-related supportive services, such as assistance with grooming and personal hygiene, securing appropriate clothing, wake-up calls, transportation, on-the-job support and crisis assistance; and

 

(e)Ongoing on-the-job performance assessment, evaluation and planning.

 

4606.15Each MCOTT Program shall provide support services for the families of MCOTT clients and other significant members of the clients' social network to assist them and the client to relate in a positive and supportive manner. These support services shall include, but are not limited to:

 

(a)Education about the client's illness and their role in the therapeutic process;

 

(b)Individual supportive counseling; and

 

(c)Intervention to resolve conflict.

 

4606.16Each MCOTT Program shall have the capacity to provide multiple contacts each week to clients experiencing severe symptoms and/or significant problems in daily living. These multiple contacts may be as frequent as two to three times per day, seven days per week.

 

4606.17Each MCOTT Program shall have the capacity to increase the service intensity to a client within hours of reported significant changes in the MCOTT client's status needs.

 

4606.18Each MCOTT Program shall provide, at a minimum, three face-to-face contacts with each MCOTT client per week.

 

source

Final Rulemaking published at 46 DCR 6122 (July 23, 1999).