N.M. Code R. § 8.321.2.19 - CRISIS INTERVENTION SERVICES
MAD pays for community-based crisis intervention services which are immediate, crisis oriented services designed to ameliorate or minimize an acute crisis episode or to prevent inpatient psychiatric hospitalization or medical detoxification. Services are provided to eligible recipients who have suffered a breakdown of their normal strategies or resources and who exhibit acute problems or disturbed thoughts, behaviors, or moods which could threaten the safety of self or others. MAD covers four types of crisis services: telephone crisis services; face-to-face crisis intervention in a clinic setting; mobile crisis services; and outpatient crisis stabilization services.
A.
Coverage criteria:
(1)
Telephone crisis services:
(a) Must
provide 24-hour, seven day-a-week telephone services to eligible recipients
that are in crisis and to callers who represent or seek assistance for persons
in a mental health crisis;
(b) The
establishment of a toll-free number dedicated to crisis calls for the
identified service area;
(c)
Assurance that a backup crisis telephone system is available if the toll-free
number is not accessible;
(d)
Assurance that calls are answered by a person trained in crisis response as
described in the BH policy and billing manual;
(e) Processes to screen calls, evaluate
crisis situation, and provide counseling and consultation to crisis callers are
documented and implemented;
(f)
Assurance that face-to-face intervention services are available immediately if
clinically indicated either by the telephone service or through memorandums of
understanding with referral sources;
(g) Provision of a toll-free number to active
clients and their support; and
(h)
A crisis log documenting each phone call must be maintained and include:
(i) date, time and duration of
call;
(ii) name of individual
calling;
(iii) responder handling
call;
(iv) description of crisis;
and
(v) intervention provided,
(e.g. counseling, consultation, referral, etc.).
(2)
Face-to-face clinic
crisis services:
(a) The provider
shall make an immediate assessment for purposes of developing a system of
triage to determine urgent or emergent needs of the person in crisis. (Note:
The immediate assessment may have already been completed as part of a telephone
crisis response.)
(b) Within the
first two hours of the crisis event, the provider will initiate the following
activities:
(i) immediately conduct the crisis
assessment;
(ii) protect the
individual (possibly others) and de-escalate the situation;
(iii) determine if a higher level of service
or other supports are required and arrange, if applicable.
(c) Follow-up. Initiate telephone call or
face-to-face follow up contact with individual within 24 hours of initial
crisis.
(3)
Mobile crisis intervention services: When mobile crisis is provided, the
response will include a two member team capable of complying with the initial
crisis requirements described in 8.321.2.19 NMAC.
(4)
Crisis stabilization services:
Outpatient services for up to 24 hour stabilization of crisis conditions
which may, but do not necessarily, include ASAM level two withdrawal
management, and can also serve as an alternative to the emergency department or
police department. Eligible population is 14 years and older.
B.
Eligible practitioners:
(1)
Telephone crisis services
(Independently licensed BH practitioner):
(a) Individual crisis workers who are
covering the crisis telephone must meet the following criteria:
(i) CPSW with one year work experience with
individuals with behavioral health condition;
(ii) Bachelor level community support worker
employed by the agency with one year work experience with individuals with a
behavioral health condition;
(iii)
RN with one year work experience with individuals with behavioral health
condition;
(iv) LMHC with one year
work experience with individuals with behavioral health condition;
(v) LMSW with one year work experience with
individuals with behavioral health condition; or
(vi) Psychiatric physician
assistant.
(b)
Supervision by a:
(i) licensed independent
behavioral health practitioner; or
(ii) behavioral health clinical nurse
specialist; or
(iii) psychiatric
certified nurse practitioner; or
(iv) psychiatrist.
(c) Training:
(i) 20 hours of crisis intervention training
that addresses the developmental needs of the full age span of the target
population by a licensed independent mental health professional with two years
crisis work experience; and
(ii) 10
hours of crisis related continuing education annually.
(2)
Mobile crisis
intervention services:
(a) Services
must be delivered by licensed behavioral health practitioners employed by a
mental health or substance abuse provider organization as described
above.
(b) One of the team members
may be a certified peer support or family peer support worker.
(3)
Crisis stabilization
services staffing must include all of the below positions and must be adequate
to serve the expected population, but not less than:
(a) one registered nurse (RN) licensed by the
NM board of nursing with experience or training in crisis triage and managing
intoxication and withdrawal management, if this service is provided during all
hours of operation;
(b) one
regulation and licensing department (RLD) master's level licensed mental health
professional on-site during all hours of operation;
(c) certified peer support worker on-site or
available for on-call response during all hours of operation;
(d) board certified physician or certified
nurse practitioner licensed by the NM board of nursing either on-site or on
call; and
(e) at least one staff
trained in basic cardiac life support (BCLS), the use of the automated external
defibrillator (AED) equipment, and first aid shall be on duty at all
times.
C.
Covered services:
(1)
Telephone crisis services:
(a) The
screening of calls, evaluation of the crisis situation and provision of
counseling and consultation to the crisis callers.
(b) Referrals to appropriate mental health
professions, where applicable.
(c)
Maintenance of telephone crisis communication until a face-to-face response
occurs, as applicable.
(2)
Face-to-face clinic crisis
services:
(a) crisis
assessment;
(b) other screening, as
indicated by assessment;
(c) brief
intervention or counseling; and
(d)
referral to needed resource.
(3)
Mobile crisis intervention
services:
(a) crisis
assessment;
(b) other screening, as
indicated by assessment;
(c) brief
intervention or counseling; and
(d)
referral to needed resource.
(4)
Crisis stabilization services:
(a) Ambulatory withdrawal management
includes:
(i) evaluation, withdrawal
management and referral services under a defined set of physician approved
policies and clinical protocols. The physician does not have to be on-site, but
available during all hours of operation;
(ii) clinical consultation and supervision
for bio-medical, emotional, behavioral, and cognitive problems;
(iii) comprehensive medical history and
physical examination of recipient at admission;
(iv) psychological and psychiatric
consultation;
(v) conducting or
arranging for appropriate laboratory and toxicology test;
(vi) assistance in accessing transportation
services for recipients who lack safe transportation.
(b) Crisis stabilization includes but is not
limited to:
(i) crisis triage that involves
making crucial determinations within several minutes about an individual's
course of treatment;
(ii) screening
and assessment;
(iii) de-escalation
and stabilization;
(iv) brief
intervention or psychological counseling;
(v) peer support; and
(vi) prescribing and administering
medication, if applicable.
(c) Navigational services for individuals
transitioning to the community include:
(i)
prescription and medication assistance;
(ii) arranging for temporary or permanent
housing;
(iii) family and natural
support group planning;
(iv)
outpatient behavioral health referrals and appointments; and
(v) other services determined through the
assessment process.
D.
Reimbursement: See
Subsection H of 8.321.9 NMAC for MAD behavioral health general reimbursement
requirements. See the BH policy and billing manual for reimbursement specific
to crisis intervention services.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.