Current through Register Vol. 50, No. 9, March 1, 2024
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
194A.050(1) requires the
secretary of the Cabinet for Health and Family Services to promulgate
administrative regulations necessary to protect the health of Kentucky citizens
and to implement programs mandated by federal law or to qualify for the receipt
of federal funds. KRS 210.450 requires the
secretary to promulgate administrative regulations governing qualifications of
personnel and standards for personnel management for community programs for
behavioral health or individuals with an intellectual disability. This
administrative regulation establishes housing assistance guidelines and the
range of community transition services to be made available to qualified
individuals diagnosed with serious mental illness residing in, or at risk of
residing in, personal care homes.
Section
1. Definitions.
(1) "Assertive
community treatment" or "ACT" means an evidence-based practice model designed
to provide treatment, rehabilitation, and support services, using a
multidisciplinary approach, to individuals who are diagnosed with a serious
mental illness. These services shall be provided in accordance with
907 KAR 15:020, Section
3(2)(j).
(2) "Case management"
means those services provided pursuant to 907 KAR Chapter 15 by a targeted case
manager eligible and trained to provide those services pursuant to
908 KAR 2:260.
(3) "Community integration supplementation"
or "CIS" means supplementation as set forth in
921 KAR 2:015, Section
6.
(4) "Crisis services" means
services that are timely and accessible and provide supports to those
individuals experiencing a behavioral health crisis as provided in 907 KAR
Chapter 15. The services may include mobile crisis teams, residential crisis
services, and twenty-four (24) hours per day/seven (7) days per week crisis
telephone lines. The services shall be offered in the least restrictive setting
possible.
(5) "Housing assistance"
means assistance in gaining access to housing in the community in accordance
with Section 3(1) of this administrative regulation. Housing in the community
does not include a personal care home, group home, nursing facility, boarding
home, assisted living residence, supervised living setting, or any setting
required to be licensed.
(6) "Peer
support services" means the social and emotional support that is provided by
persons having a mental health, substance use, or co-occurring disorder to
others with a similar disorder, in order to bring about a desired social or
personal change as provided in 907 KAR Chapter 15.
(7) "Person centered recovery plan" means a
treatment and recovery plan created for adults with SMI, which is developed
with the individual, the designated clinician, and any other parties designated
by the individual. This plan shall build upon identified strengths, wants, and
needs of each individual.
(8)
"Personal care home" or "PCH" means a facility licensed as a personal care home
and regulated by
902 KAR 20:031 and
902 KAR 20:036.
(9) "Provider" means a community mental
health center (CMHC), its affiliate provider organizations, and any individual
or organization qualified to provide behavioral health service, including
behavioral health services organizations (BHSO).
(10) "Serious mental illness" or "SMI" means
a mental illness or disorder (but not a primary diagnosis of Alzheimer's
disease or dementia), that is described in the Diagnostic and Statistical
Manual of Mental Disorders (DSM), 5th Edition, or the DSM currently in use,
that impairs or impedes functioning in one (1) or more major areas of living
and is unlikely to improve without treatment, services, or supports.
(11) "Supported employment services" means
services that will assist individuals in preparing for, identifying, and
maintaining integrated, paid, competitive employment. Services may include job
coaching, transportation, assistive technology, specialized job training,
person centered employment plans, job development, and individually-tailored
supports.
(12) "Tenancy rights"
means rights created by a landlord/tenant relationship whether through a direct
lease or sublease in which the individual is identified as the
tenant.
Section 2.
Eligibility. An adult with a serious mental illness shall be considered
eligible for housing assistance and supported employment services in addition
to other services found to be medically necessary under this administrative
regulation if the individual:
(1) Has
expressed a desire to live in permanent housing with tenancy rights;
(2) Is eligible for Medicaid
services;
(3) Is at least eighteen
(18) years of age;
(4) Is living in
or at risk of living in a personal care home; and
(5) Is categorically eligible for community
integration supplementation pursuant to
921 KAR 2:015, Section
6.
Section 3. Services.
(1) Housing assistance under this
administrative regulation shall:
(a) Allow
choice in activities of daily living, social interaction, and access to the
community; and
(b) Be offered to
enable individuals to attain and maintain integrated, affordable housing that:
1. Is scattered site housing, where no more
than twenty-five (25) percent of the units in any development are occupied by
individuals with a disability, as defined by the Americans with Disabilities
Act, actually known to the cabinet; and
2. Does not limit access to community
activities.
(2)
Supportive services in accordance with a person centered recovery plan
developed pursuant to Section 4 of this administrative regulation may include:
(a) ACT;
(b) Case Management;
(c) Covered services as set forth in
907 KAR 3:130;
(d) Crisis services;
(e) Peer support services; or
(f) Supported employment
services.
Section
4. Transition Process. An individual shall:
(1) Be evaluated by a qualified mental health
provider to determine eligibility for and the clinical appropriateness of the
transition;
(2) Receive information
about available services under this administrative regulation including CIS
eligibility pursuant to
921 KAR 2:015, Section
6;
(3) Work with a team to develop
a person centered recovery plan that shall include all necessary services,
objectives, plans, and interventions; and
(4) Be offered assistance in developing an
advance directive for mental health treatment and wellness and crisis
plans.
Section 5. Appeal
Rights. An individual may appeal a department decision pursuant to this
administrative regulation in accordance with
907 KAR 1:563.