Mississippi Administrative Code
Title 24 - Mental Health
Part 2 - Operational Standards for Mental Health, Intellectual/Developmental Disabilities, and Substance Use Community Service Providers
Chapter 32 - Intensive Community Supports for Serious Emotional Disturbance and Serious Mental Illness
Rule 24-2-32.7 - Program of Assertive Community Treatment Required Services
Universal Citation: MS Code of Rules 24-2-32.7
Current through September 24, 2024
A. Operating as a continuous treatment service, the Program of Assertive Community Treatment Team must have the capability to provide comprehensive treatment, rehabilitation, and support services as a self-contained service unit. Services must minimally include the following (1-11):
1. Service
Coordination/Individual Treatment Team
(a)
Each person will be assigned one (1) member of the Program of Assertive
Community Treatment Team to serve as a service coordinator who coordinates and
monitors the activities of the person's individual treatment team (ITT) and the
greater Program of Assertive Community Treatment Team. The primary
responsibility of the service coordinator is to work with the person to write
the Individual Service Plan, to provide individual supportive counseling, to
offer options and choices in the Individual Service Plan, to ensure that
immediate changes are made as the person's needs change, and to advocate for
the person's wishes, rights, and preferences. The service coordinator is also
the first employee called on when the person is in crisis and is the primary
support person and educator to the person and/or person's family. Members of
the person's treatment team share these tasks with the service coordinator and
are responsible to perform the tasks when the service coordinator is not
working. Service coordination also includes coordination with community
resources, including self-help and advocacy organizations that promote
recovery.
(b) Each person will be
assigned to an individual treatment team. The individual treatment team is a
group or combination of three to five (3-5) Program of Assertive Community
Treatment personnel who together have a range of clinical and rehabilitation
skills and expertise. The individual treatment team members are assigned to
work with a person receiving services by the team leader and the
psychiatrist/psychiatric nurse practitioner by the time of the first Individual
Service Planning meeting or thirty (30) days after admission. The core members
of the individual treatment team are the service coordinator, the
psychiatrist/psychiatric nurse practitioner, and one (1) clinical or
rehabilitation personnel who shares case coordination tasks and substitutes for
the service coordinator when he or she is not working. The individual treatment
team has continuous responsibility to:
1) be
knowledgeable about the person's life, circum- stances, goals and desires;
2) collaborate with the person to
develop and write the Individual Service Plan;
3) offer options and choices in the
Individual Service Plan;
4) ensure
that immediate changes are made as a person's needs change; and,
5) advocate for the person's wishes, rights,
and preferences. The individual treatment team is responsible for providing
much of the person's treatment, rehabilitation, and support services.
Individual treatment team members are assigned to take separate service roles
with the person as specified by the person and the individual treatment team in
the Individual Service Plan.
2. Crisis Assessment and Intervention
(a) Crisis assessment and intervention must
be provided twenty-four (24) hours per day, seven (7) days per week. These
services will include telephone and face-to-face contact and will be provided
in conjunction with the local community mental health system's emergency
services program as appropriate.
(b) A system must be in place that assures
the person can contact the Program of Assertive Community Treatment Team as
necessary.
3. Symptom
Assessment and Management includes but is not limited to the following:
(a) Ongoing comprehensive assessment of the
person's mental illness symptoms, accurate diagnosis, and the person's response
to treatment.
(b) Psycho-education
regarding mental illness and the effects and side effects of prescribed
medications.
(c) Symptom-management
efforts directed to help each person identify/target the symptoms and
occurrence patterns of his or her mental illness and develop methods (internal,
behavioral, or adaptive) to help lessen the effects.
(d) Individual supportive therapy.
(e) Psychotherapy.
(f) Generous psychological support to people,
both on a planned and as-needed basis, to help them accomplish their personal
goals, to cope with the stressors of day-today living, and to
recover.
4. Medication
Prescription, Administration, Monitoring and Documentation
(a) The Program of Assertive Community
Treatment Team psychiatrist/psychiatric nurse practitioner must:
(1) Establish an individual clinical
relationship with each person.
(2)
Assess each person's mental illness symptoms and provide verbal and written
information about mental illness.
(3) Make an accurate diagnosis based on the
comprehensive assessment which dictates an evidence-based medication pathway
that the psychiatrist/psychiatric nurse practitioner will follow.
(4) Provide education about medication,
benefits and risks, and obtain informed consent.
(5) Assess and document the person's mental
illness symptoms and behavior in response to medication and monitor and
document medication side effects.
(6) Provide psychotherapy.
(b) All Program of Assertive
Community Treatment Team members must regularly assess and document the
person's mental illness symptoms and behavior in response to medication and
must monitor for medication side effects. This information should be shared
with the prescriber.
(c) The
Program of Assertive Community Treatment Teams must establish medication
policies and procedures which identify processes to:
(1) Record physician orders;
(2) Order medication;
(3) Arrange for all individual medications to
be organized by the team and integrated into people's weekly schedules and
daily employee assignment schedules;
(4) Provide security for medications (e.g.,
daily and longer-term supplies, and long-term injectables) and set aside a
private designated area for set-up of medications by the team's nursing
personnel;
(5) Administer
medications per state law to people receiving Program of Assertive Community
Treatment services; and,
(6) Comply
with Rule
13.8.
5. Co-Occurring Substance Use Services
(a) Co-Occurring Substance Use Services are
the provision of a stage-based treatment model that is non-confrontational,
considers interactions of mental illness and substance use, and has
individual-determined goals. This must include but is not limited to individual
and group interventions in:
(1) Engagement
(e.g., empathy, reflective listening, avoiding argumentation);
(2) Assessment (e.g., stage of readiness to
change, individual-determined problem identification);
(3) Motivational enhancement (e.g.,
developing discrepancies, psycho-education);
(4) Active treatment (e.g., cognitive skills
training, community reinforcement); and,
(5) Continuous relapse prevention (e.g.,
trigger identification, building relapse prevention action plans).
6. Work-Related
Services
(a) Work-related services to help
people value, find, and maintain meaningful employment in community-based job
sites and services to develop jobs and coordinate with employers but also
includes but is not necessarily limited to:
(1) Assessment of job-related interests and
abilities through a complete education and work history assessment as well as
on-the-job assessments in community-based jobs.
(2) Assessment of the effect of the person's
mental illness on employment with identification of specific behaviors that
interfere with the person's work performance and development of interventions
to reduce or eliminate those behaviors and find effective job
accommodations.
(3) Development of
an ongoing employment plan to help each person establish the skills necessary
to find and maintain a job.
(4)
Individual supportive therapy to assist people to identify and cope with mental
illness symptoms that may interfere with their work performance.
(5) On-the-job or work-related crisis
intervention.
(6) Work-related
supportive services, such as assistance with grooming and personal hygiene,
securing of appropriate clothing, wake-up calls, and transportation, if
needed.
7.
Activities of Daily Living
(a) Services to
support activities of daily living in community-based settings include
individualized assessment, problem solving, sufficient side-by-side assistance
and support, skill training, ongoing supervision (e.g., prompts, assignments,
monitoring, encouragement), and environmental adaptations to assist people to
gain or use the skills required to:
(1) Find
housing which is safe, of good quality, and affordable (e.g., apartment
hunting; finding a roommate; landlord negotiations; cleaning, furnishing, and
decorating); and, procuring necessities (such as telephones, furnishings,
linens).
(2) Perform household
activities, including house cleaning, cooking, grocery shopping, and
laundry.
(3) Carry out personal
hygiene and grooming tasks, as needed.
(4) Develop or improve money-management
skills.
(5) Use available
transportation.
(6) Have and
effectively use a personal physician and dentist.
8. Social/Interpersonal
Relationship and Leisure-Time Skill Training
(a) Services to support social/interpersonal
relationships and leisure-time skill training include supportive individual
therapy (e.g., problem solving, role-playing, modeling, and support);
social-skill teaching and assertiveness training; planning, structuring, and
prompting of social and leisure-time activities; side-by-side support and
coaching; and, organizing individual and group social and recreational
activities to structure people's time, increase their social experiences, and
provide them with opportunities to practice social skills and receive feedback
and support required to:
(1) Improve
communication skills, develop assertiveness, and increase
self-esteem;
(2) Develop social
skills, increase social experiences, and develop meaningful personal
relationships;
(3) Plan appropriate
and productive use of leisure time;
(4) Relate to landlords, neighbors, and
others effectively; and,
(5)
Familiarize themselves with available social and recreational opportunities and
increase their use of such opportunities.
9. Peer Support Services
(a) Services to validate people's experiences
and to guide and encourage people to take responsibility for and actively
participate in their own recovery. In addition, services to help people
identify, understand, and combat stigma and discrimination against mental
illness and develop strategies to reduce people's self-imposed
stigma;
(b) Peer counseling and
support; and,
(c) Introduction and
referral to self-help services and advocacy organizations that promote
recovery.
10. Support
Services
(a) Support services or direct
assistance to ensure that people obtain the basic necessities of daily life,
including but not necessarily limited to:
(1)
Medical and dental services;
(2)
Safe, clean, affordable housing;
(3) Financial support and/or benefits
counseling (e.g., SSI, SSDI, Food Stamps, Section 8, Vocational Rehabilitation,
Home Energy Assistance);
(4) Social
services;
(5) Transportation;
and,
(6) Legal advocacy and
representation.
11. Education, Support, and Consultation to
People's Families and other Major Supports
(a)
Services provided regularly under this category to people's families and other
major supports, with individual agreement or consent, include:
(1) Individualized psycho-education about the
person's illness and the role of the family and other significant people in the
therapeutic process;
(2)
Intervention to restore contact, resolve conflict, and maintain relationships
with family and/or other significant people;
(3) Ongoing communication and collaboration,
face-to-face and by telephone, between the Program of Assertive Community
Treatment's Team and the family;
(4) Introduction and referral to family
self-help services and advocacy organizations that promote recovery;
(5) Assistance to people with children
(including individual supportive counseling, parenting training, and service
coordination) including but not limited to:
i.
Services to help people throughout pregnancy and the birth of a child;
ii. Services to help people fulfill
parenting responsibilities and coordinate services for the child/children; and,
iii. Services to help people
restore relationships with children who are not in the person's custody.
Section 41-4-7 of the Mississippi Code, 1972, as Amended
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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