New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 321 - SPECIALIZED BEHAVIORAL HEALTH SERVICES
Part 2 - SPECIALIZED BEHAVIORAL HEALTH PROVIDER ENROLLMENT AND REIMBURSEMENT
Section 8.321.2.19 - CRISIS INTERVENTION SERVICES

Universal Citation: 8 NM Admin Code 8.321.2.19

Current through Register Vol. 35, No. 18, September 24, 2024

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.

Disclaimer: These regulations may not be the most recent version. New Mexico 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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