016.06.11 Ark. Code R. 012 - Rehabilitative Services for Persons with Mental Illness (RSPMI) Update No. 4-11

Section II. Rehabilitative Services for Persons with Mental Illness

202.100 Certification Requirements by the Division of Behavioral Health

Services (DBHS)

Providers of RSPMI Services must furnish documentation of certification from the Division of Behavioral Health Services (DBHS) establishing that the provider is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Comprehensive Accreditation Manual for Behavioral Health Care, the Commission on Accreditation of Rehabilitation Facilities (CARF) Behavioral Health Standards Manual and the Council on Accreditation (COA) Outpatient Mental Health Services Manual. Accreditation must recognize and include all the applicant's programs, services and service sites. Any outpatient behavioral health program associated with a hospital must have a free-standing behavioral health outpatient program national accreditation. Providers must meet all other certification requirements in addition to accreditation.

Certification requirements may be found at www.arkansas.gov/dhs/dmhs/.

211.000 Coverage of Services

Rehabilitative Services for Persons with Mental Illness (RSPMI) are limited to certified providers who offer core mental health services for the treatment and prevention of mental disorders. The provider must be certified as an RSPMI provider by the Division of Behavioral Health Services.

An RSPMI provider must establish a site specific emergency response plan that complies with section VIII(N) of the Arkansas Department of Human Services Division of Behavioral Health Services Certification Manual. Each site must have 24-hour emergency response capability to meet the emergency treatment needs of the RSPMI beneficiaries served by the site. The provider must implement and maintain a written policy reflecting the specific coverage plan to meet this requirement. An answering machine message to call 911 or report to the nearest emergency room in and of itself is not sufficient to meet the requirement.

212.000 Quality Assurance

Each RSPMI provider must establish and maintain a quality assurance committee that will meet quarterly and examine the clinical records for completeness, adequacy and appropriateness of care, quality of care and efficient utilization of provider resources. The committee must also comply with section VIII(P) of the Arkansas Department of Human Services Division of Behavioral Health Services Certification Manual. Documentation of quality assurance committee meetings and quality improvement programs must be filed separately from the clinical records.

213.000 Staff Requirements

Each RSPMI provider shall ensure that mental health professionals are available to provide appropriate and adequate supervision of all clinical activities. RSPMI staff members must provide services only within the scope of their individual licensure. It is the responsibility of the facility to credential each clinical staff member, specifying the areas in which he or she can practice based on training, experience and demonstrated competence.

Each RSPMI provider shall comply with minimum staffing requirements set forth in section VIII(E) of the Arkansas Department of Human Services Division of Behavioral Health Services Certification Manual.

In addition to minimum staff requirements, the RSPMI provider may employ additional mental health professionals who shall meet all professional requirements as defined in the state licensing and certification laws relating to their respective professions. Examples include:

1. Psychiatrist

2. Physician

3. Psychologist

4. Psychological Examiner

5. Adult Psychiatric Mental Health Clinical Nurse Specialist

6. Child Psychiatric Mental Health Clinical Nurse Specialist

7. Adult Psychiatric Mental Health Advanced Nurse Practitioner

8. Family Psychiatric Mental Health Advanced Nurse Practitioner

9. Master of Social Work (Licensed in the State of Arkansas)

10. Registered nurse (RN; licensed in the State of Arkansas) who has one (1) year supervised experience in a mental health setting (Services provided by the RN must be within the scope of practice specified by the RN's licensure)

11. Licensed professional counselor (Licensed in the State of Arkansas)

12. Persons in a related profession who are licensed in the State of Arkansas and practicing within the bounds of their licensing authority, with a master's degree and appropriate experience in a mental health setting, including documented, supervised training and experience in diagnosis and therapy of a broad range of mental disorders

A. The services of a medical records librarian are required. The medical records librarian (or person performing the duties of the medical records librarian) shall be responsible for ongoing quality controls, for continuity of patient care and patient traffic flow. The librarian shall assure that records are maintained, completed and preserved; that required indexes and registries are maintained and that statistical reports are prepared. This staff member will be personally responsible for ensuring that information on enrolled patients is immediately retrievable, establishing a central records index, and maintaining service records in such a manner as to enable a constant monitoring of continuity of care.

B. A mental health paraprofessional is defined as a person with a Bachelor's Degree or a license from the Arkansas State Board of Nursing who does not meet the definition of mental health professional, but who is licensed and certified by the State of Arkansas in a related profession and is practicing within the bounds as permitted by his or her licensing authority, or a person employed by a certified RSPMI provider with a high school diploma or general equivalency diploma (GED) and documented training in the area of mental health. A mental health paraprofessional may provide certain Rehabilitative Services for Persons with Mental Illness under direct supervision of a mental health professional as set forth in section VIII(E) (4) of the Arkansas Department of Human Services Division of Behavioral Health Services Certification Manual. The services paraprofessionals may provide are: crisis stabilization intervention, on-site intervention, off-site intervention, rehabilitative day service, therapeutic day/acute day treatment and collateral service. If the paraprofessional is a licensed nurse, the following services may also be provided: medication administration by a licensed nurse, routine venipuncture for collection of specimen and catheterization for collection of specimen.

Effective for dates of service on and after October 1, 2008, when an RSPMI provider files a claim with Arkansas Medicaid, the staff member who actually performed the service on behalf of the RSPMI provider must be identified on the claim as the performing provider. RSPMI staff members who are eligible to enroll in the Arkansas Medicaid program have the option of either enrolling or requesting a Practitioner Identification Number (View or print form DMS-7708) so --[ Field Code changed )

that they can be identified on claims. For example, an LCSW may choose to enroll in the Licensed Mental Health Practitioners program or choose to obtain a Practitioner Identification Number.

This action is taken in compliance with the federal Improper Payments Information Act of 2002 (IPIA), Public Law 107-300 and the resulting Payment Error Rate Measurement (PERM) program initiated by the Centers for Medicare and Medicaid Services (CMS).

Certain types of practitioners who perform services on behalf of an RSPMI provider cannot enroll in the Arkansas Medicaid program. These practitioners must request a Practitioner Identification Number so that they can be identified on claims:

* Psychological Examiner

* Adult Psychiatric Mental Health Clinical Nurse Specialist

* Child Psychiatric Mental Health Clinical Nurse Specialist

* Adult Psychiatric Mental Health Advanced Nurse Practitioner

* Family Psychiatric Mental Health Advanced Nurse Practitioner

* Master of Social Work (Licensed in the State of Arkansas)

* Regi stered nurse

* Paraprofessional

Notes

016.06.11 Ark. Code R. 012

7/14/2011