Current through 2024-38, September 18, 2024
A. Approved Staff. Approved staff are those
staff who may deliver homebased family mental health services as defined in
Section IV. Personnel below.
B.
Bureau of Children with Special Needs. The Bureau of Children with Special
Needs is an administrative unit of the Maine Department of Mental Health and
Mental Retardation pursuant to 34-B M.R.S.A., Section6204.
C. Collateral Contacts. Collateral contacts
are face-to-face contacts on behalf of participating family members to gather
information or to discuss the case with other professionals, caregivers, or
others (including other family members) not included in the service plan as
treatment recipients, for the purpose of improving the coordination of service
to a family by different service providers, to achieve both a continuity of
care, and the most appropriate mix of services.
D. Counseling Services. Counseling services
engage individuals, family members, and entire families as appropriate in
problem solving discussions to promote positive orientation, relief of excess
stress, and growth toward more integrated and independent levels of functioning
of the family. Services are delivered through planned interaction involving the
use of physiological, psychological, ecological, and sociological evaluation
and interventive concepts, techniques, and processes. These services will be
focused on the special development and emotional needs and problems of the
child.
E. Discharge Plan. A
discharge plan is a written plan outlining the criteria and processes by which
discharge will occur. Discharge plans shall be included in the individualized
service plan for each participating family member.
F. Evaluation. Evaluation is an assessment of
an individual's needs, which is based in part on the result of at face-to-face
meeting with the individual, which includes a delineation of an individual's
family-oriented needs, and which includes medical. and social history, and is
prepared by an approved staff member.
G. Homebased Family Services. Homebased
family services are short-term, time-limited, crisis-oriented family counseling
services and psychotherapy, provided by a team of qualified personnel, in a
family's home or other appropriate setting, for the purpose of preventing the
removal of one or more children from the home, or to promote reunification of
the family when a child, once removed from the family, is returned to the
family. Homebased family services help families improve their ability to find,
select, and use appropriate community supports.
H. Psychotherapy. Psychotherapy is the
utilization by legally qualified personnel of psychological and interpersonal
theories and related practice methodologies to assess, interpret or modify
conscious and unconscious processes of behavior. The therapy process may
include:
(1) Examination of ongoing adaptive
and maladaptive behavior/relationship patterns and contributing
dynamics.
(2) The reorganizations
of elements in such a way that they take on new meaning and provide for the
conditions to reach new solutions.
I. Service Plan. A. service plan is an
individualized written plan of homebased family services which is prepared for
each family member receiving homebased family services, and is based on an
evaluation of the family member's and the family's mental health needs. The
service plan must be endorsed by an approved staff member, and must meet the
standards for individualized service plans as set forth in Section 400.04(D)
(6) (c) of the Regulations for Licensing Mental Health Facilities. and,
depending on the age of the individual for whom the service plan is drawn,
either Part C., Section II of the Rights of Recipients of Mental Health
Services, published pursuant to 34-B M.R.S.A., Section3003, or, Part C, Section
II of the Rights of Recipients of Services Who Are Children in Need of
Treatment, published pursuant to 34-B M.R.S.A., Section6204(6)(C).
J. Teams. Teams for the delivery of homebased
family services consist of from one to three approved staff members, according
to needs specified in the service plan.
ADMISSIONS CRITERIA
A. Eligibility for admission to homebased
family services, requires that families meet either criterion 1 or 2 listed
below in this section, in addition to the entire criterion in section II.B.
below.
When a child is residing with his/her family at the time the
family applies for homebased family services, eligibility will be determined on
the basis of:
(1) An evaluation
performed by an approved staff member which concludes that a child is at risk
of removal from his/her family. This documentation of the evaluation must
delineate the criteria and procedures used for assessing said risk. This
documentation must be preserved in the child's case file at the homebased
family services agency.
Written policies and procedures which homebased family
services agencies must develop to prioritize admissions for those families with
children at most immediate risk of removal.
(2) When a child resides outside of his/her
family's residence and the family applies for reunification services from the
homebased family services agency, eligibility for admission to homebased family
services will be determined on the basis of:
a. An evaluation which concludes that
homebased family services are necessary to assist in the successful return of a
child to his/her family's home, and that no other agency or program is capable
or appropriate to deliver this type of reunification service to the family.
This evaluation or professional assessment must be preserved in the child's
case file at the homebased family services agency.
b. Written admissions criteria which
homebased family services agencies must develop which clearly define the
characteristics, of children appropriate for admission under this criteria.
Definitions will include, but need not-be limited to, the types of out-of-home
placements where eligible children reside at time of intake.
c. written policies and procedures which
homebased family services agencies must develop under this criteria which
ensure priority for those families most in need of this service to assist in
the successful permanent return of the child to his/her family.
B. Eligibility for
admission to homebased family services requires that families meet all of the
criteria contained in this subsection, in addition to meeting the criteria of
either Subsection II.A. l. or Subsection II.A.2. above.
(1) Families may be eligible for this service
only where at least one adult family member is willing to participate in the
service.
a. The program shall adopt admissions
procedures which clearly define adult willingness to participate, and the
procedures for assessing this willingness.
b. The program shall adopt written policies
and procedures which delineate the program's responsibilities for referring
families to providers of other appropriate services where families are denied
homebased family services under this admission criterion.
(2) Families may be eligible for this service
only where it is neither possible, nor appropriate for the family to use
another service which is less intensive than Homebased Family Services; or
where other types of services have been attempted or provided without success.
a. The program shall produce written
admissions procedures which delineate procedures for assessing eligibility
under this criterion. These procedures shall specify types of information and
documentation necessary at time of intake in order to accurately assess the
family's need for this particular service; the inappropriateness of other
services; and/or the family's lack of success in other less intensive
services.
b. The program shall
produce written policies and procedures which delineate the program's
responsibilities for information and referral to other services where families
are deemed not appropriate for admission under this criterion.
PROVISION OF SERVICES
A. Services shall include the following,
consistent with available resources. Programs funded by the Bureau of Children
with Special Needs shall provide the following services:
(1) Initial evaluation of the needs of the
family, including a medical and social history. This family-oriented evaluation
will be completed in addition to the assessment data required under Section
400.04(D)(5) of the Regulations for Licensing Mental Health Facilities of the
Department of Mental Health and Mental Retardation.
(2) Development of a service plan to address
identified needs.
a. The program shall ensure
that service plans are developed and maintained in accordance with the general-
or comprehensive-service licensing standards in the Regulations for Licensing
Mental Health Facilities [particularly Regulation 400.04 (D) (6) (c) ] of the
Department of Mental Health and Mental Retardation.
b. Service plans of Homebased Family Services
programs must additionally specify the services to be provided, the expected
duration of each service to be provided, the frequency and duration of each
phase of service, identification of who will provide each planned service, and
the goals and expected outcome of each planned service. Due to the time-limited
nature of Homebased Family Services, the service plan must be reviewed and
updated whenever there is a change in any aspect of the service plan.
c. The program shall ensure that an
appropriate service plan is developed for each participating family member by
the end of the third visit or ten (10) working days, whichever comes
last.
(3) Counseling
services for the family members, provided either to individual family members
or to groups of family members, to address goals listed on the service
plan(s).
(4) Collateral
contacts.
B.
Psychotherapy may be provided only where:
(1)
Homebased family service staff providing psychotherapy are legally qualified to
provide this service; and,
(2)
Psychotherapy is necessary to accomplish the goals identified in the service
plan; and,
(3) Psychotherapy cannot
more appropriately be delivered through another, less intensive
service.
C. The program
shall produce written procedures for staff scheduling which ensure service
delivery in a flexible manner appropriate to accomplishing goals set forth in
the service plan. Specifically,
(1) Staff
scheduling procedures should enable homebased family services to be provided at
varying levels of intensity during the course of planned services (for example:
clients/families may be seen more frequently and for longer sessions during the
first few -weeks of service, and then taper down to briefer and less frequent
sessions/visits by the end of the 13-week period of hamebased family services);
and,
(2) Services shall be
available to families in their homes at time convenient to family members" work
and school schedules, except that no Homebased Family Services provider will be
expected to serve clients between the hours of 11:00 PM and 7:00 AN.
D. The program shall establish a
time frame for length of service which shall not exceed 13 weeks of service to
be delivered within 18 calendar weeks. The first week of service is that week
within which the first face-to-f ace contact with a member of the family
occurs.
(1) Should the service be delivered in
a nonconsecutive thirteen week period, documentation of the necessity for the
interrupted service shall be contained in the clinical record, and the dates of
interrupted service shall be reflected in the service plan.
(2) Extension of service beyond the thirteen
(13) weeks must be approved by licensed clinical staff and such approval must
be documented in the clinical record, and the dates of the approved period of
extended service reflected on the service plan.
E. The service shall be delivered by a
team.
F. The process of case
closure shall begin at the outset of services with a discharge plan included in
the service plan, and shall itself serve a purpose within the course of
counseling. Programs must meet the following criteria in addition to the
discharge criteria contained in
Section 400.04(A)(4) of the Regulations for Licensing Mental
Health Facilities of the Department of Mental Health and Mental
Retardation.
(1) The program shall
produce policies and procedures to ensure that cases are closed when:
a. Goals have been accomplished;
b. It is realized that there is insufficient
time to accomplish the goals needed to address the family's problems;
c. The identified client/patient no longer
remains in the home and the agency clinical director, or the licensed
professional fulfilling those duties, certifies that the services are no longer
appropriate to meet the needs of the individuals in the family; or
d. In the opinion of -toe agency clinical
director the services are not appropriate to meet the family's needs.
(2) The program shall produce
policies and procedures to ensure that a discharge/closing summary is included
in each clinical record. The summary shall include:
a. Indicators used to determine program
completion;
b. Provisions for
referral of recipient to other programs in the community upon case closure when
appropriate; and
c. A statement of
each goal listed on the recipients service plan, a determination of whether
each goal listed on the service plan for each individual recipient was
successfully or unsuccessfully completed, and the reasons for the
determination.
G. The program shall limit its services to
those designed to eliminate the risk of removal of the child from the family,
and which are consistent with goals set forth in the service plan.
(1) The program shall develop written
policies and procedures for referral to, and cooperation with, appropriate
local crisis/emergency services.
(2) The program shall maintain an up-to-date
directory of local crisis/emergency services for staff members to use as a
resource.
H. All
services shall be delivered in accordance with the Rights of Recipients of
Mental Health Services, or the Rights of Recipients of Services Who Are
Children in Need of Treatment, or any subsequent revision applicable to
children or families.
(1) The program shall
develop procedures for informing recipients of their rights. Each clinical
record shall contain documentation that these rights informing procedures were
fulfilled.
(2) The program shall
develop procedures for training staff in these rights.
PERSONNEL
A. The
Program shall establish personnel policies in accordance with stipulations in
the regulations for licensing at the general- or comprehensive-service level of
the Department of Mental Health and Mental Retardation.
B. The program shall provide evidence that
the licensure/certification of all licensed/certified staff is current, and
that the training and supervisory provisions of said licenses/certifications
are maintained.
C. The program
shall provide evidence of an active plan for staff development, in accordance
with Section 400.03(E) of the regulations for licensing at the general- or
comprehensive-service level in the Regulations- for Licensing Mental Health
Facilities of the Department of Mental Health and Mental Retardation. Staff
development plans shall be based on the annual. individual staff development
assessments cited above in Section 400.03(E) I and should also specifically
address the improvement of staff ability to provide high quality homebased
family services.
D. Approved staff
-of homebased family services agencies are as follows:
(1) Psychiatrist. A psychiatrist must be
certified by the American board of Psychiatry and Neurology, or be eligible for
examination by the American Board as documented by written evidence from such
Board, or have completed 3 years of post graduate training psychiatry approved
by the Educational council of the American Medical Association and have written
evidence of such training; and have current and valid licensure as a physician
by the Maine Board of Registration of Medicine.
(2) Licensed Clinical Staff. Licensed
clinical staff may diagnose, supervise, and approve service plans, as permitted
within the scope of their licensure, in addition to providing counseling
services:
a. Psychologist. A psychologist must
be licensed as a psychologist in the state or province in which practicing as
documented by written evidence from the appropriate governing Board.
b. Licensed Clinical Social Worker (LCSW). A
Licensed Clinical Social Worker must be licensed as such by the Maine State
Board of Social Work Licensure in accordance with 32 M.R.S.A., Chapter 83, as
documented by written evidence from such Board, or is qualified and scheduled
for licensure examination as evidenced by a conditional license.
c. Licensed Substance Abuse Counselor (LSAC).
A Licensed Substance Abuse Counselor must be licensed by the State Board of
Substance Abuse Counselors in accordance with 32 M.R.S.A., Chapter 81 and
possess written evidence of such licensure from that Board.
d. Licensed Clinical Professional Counselor
ACES, A Licensed Clinical Professional Counselor must be licensed by the Maine
State Board of Counseling Professionals Licensure in accordance with 32
M.R.S.A., Chapter 119, as documented by written evidence from that
Board.
e. Licensed Master Social
Worker, Conditional II (LMSW-Conditional III, A Licensed Master Social
Worker-Conditional II, must be licensed as such by the Maine State Board of
Social Work Licensure in accordance with 32 M.R.S.A., Chapter 83, as documented
by written evidence from such Board.
(3) Licensed Master Social Worker (LMSW). A
Licensed Master Social Worker must be licensed as such by the Maine State Board
of Social Work Licensure in accordance with 32 M.R.S.A., Chapter 83, Section
7001, as documented by written evidence from such Board, or is qualified and
scheduled for licensure examination as evidenced by a Licensed Master Social
Worker, Conditional I license.
(4)
Licensed Psychological Examiner (LPE). A Licensed Psychological Examiner must
be licensed as a psychological examiner by the Maine Board of Examiners of
Psychologists, as documented by written evidence from that Board.
(5) Psychiatric Nurse (RN). A psychiatric
nurse must be licensed as a registered professional nurse by the Maine State
Board of Nursing, and must either hold a Master's or higher degree in
psychiatric or mental health nursing awarded from an accredited institution of
higher learning or be certified by the American Nurses' Association as a
psychiatric and mental health nurse, a clinical specialist in adult psychiatric
and mental health nursing, or a clinical specialist in child and adolescent
psychiatric and mental health nursing.
(6) Licensed Professional Counselor (LPC). A
licensed professional counselor must be licensed as such by the Maine State
Board of Counseling Professionals Licensure in accordance with 32 M.R.S.A.,
Chapter 119, as documented by written evidence from that Board.
(7) Licensed Marriage and Family Therapist
(LM&FT). A licensed marriage and family therapist must be licensed as such
by the Maine State Board of Counseling Professionals Licensure in accordance
with 32 M.R.S.A., Chapter 119, as documented by written evidence from that
Board.
(8) Licensed Pastoral
Counselor (LPC). A. licensed pastoral counselor must be licensed as such by the
Maine State Board of Counseling Professionals Licensure in accordance with 32
M.R.S.A., Chapter 119, as documented by written evidence from that
Board.
(9) Qualified Mental Health
Professionals (QMHP). Qualified Mental Health Professionals are those
individuals other than defined above who have appropriate education, training,
and experience as approved by the Bureau of Children with Special Needs. In
accordance with the regulations for licensing at the general or comprehensive
service level of the Department of Mental Health and Mental Retardation, the
program shall submit to the Bureau of Children with special Needs for approval
names and qualifications of personnel defined as qualified mental health
professionals.
a. The program shall provide
evidence that qualified mental health professionals have attained at minimum a
bachelors degree in the psychology, social work, child development or related
field from an accredited college or university; or, a bachelors degree in
another field, and advanced training in one or more of the above disciplines.
In addition, the program shall provide evidence based on work experience and
training of the abilities of the candidates for qualified mental health
professional to responsibly execute the professional obligations of homebased
family services counselors. Exceptions to the above minimum criteria will be
made by the Director of the Bureau of Children with Special Needs on a
case-by-case basis.
b. QMHP staff
must work under regular, documented supervision by licensed clinical staff at a
frequency that complies at minimum with the stipulations; in Section 400.03(D)
(2) (b) of the Regulations for Licensing Mental Health Facilities of the
Department of Mental Health and Mental Retardation.
(10) Contract staff. Contract staff are
licensed professional and other qualified staff who provide homebased family
services under a consultant arrangement, subcontract, or cooperative agreement
approved by the Bureau of Children with special needs, in accordance with their
classification as professional staff or qualified mental health professionals.
a. The program must provide evidence that
contract staff adhere to all applicable personnel requirements for licensure
and/or certification, staff development, and clinical supervision.
b. The program must submit a listing of all
contract staff members annually on the first day of April of each year, as well
as staffing changes, as needed to the Bureau of Children with special
Needs.
