1. health and fitness
2. disorders

PSYCHIATRIC DAY TREATMENT
PROGRAM
Providers contracted for this level of care or service will be expected to comply with all
requirements of these service specific performance specifications. Additionally, providers of
this service and all contracted services will be held accountable to the “General”
performance specifications, located at the beginning of this section of the Provider Manual.
The Performance Specifications contained herein pertain to the following services:
•
Psychiatric Day Treatment Program
•
Enhanced Psychiatric Day Treatment Program
Please refer to the performance specification attachment for this specialty service.
The Psychiatric Day Treatment Program provides a coordinated set of individualized,
integrated, and therapeutic supportive services to Members with psychiatric disorders, who
need more active or inclusive treatment than is typically available through traditional
outpatient mental health services.
While less intensive than partial hospitalization, day treatment is an intensive, clinical
program that includes diagnostic, medical, psychiatric, psychosocial, and adjunctive treatment
modalities in a structured setting. Day treatment programs provide rehabilitative, prevocational, educational, and life-skill services to promote recovery and attain adequate
community functioning, with focus on peer socialization and group support.
Day treatment assists Members in beginning the recovery and rehabilitation process and may
provide supportive transitional services to Members who are no longer acutely ill, require
moderate supervision to avoid risk, and/or are not fully able to re-enter the community or the
workforce.
Providers should ensure that the Member has opportunities and support for involvement in
community, social, and leisure-time programs, as well as opportunities to pursue personal,
ethnic, and cultural interests. Services are usually provided in a community setting. A goaldirected treatment plan developed with the member and/or family will guide the course of
treatment. Active family/significant other involvement is important unless contraindicated.
Frequency should occur based on individual needs.
Components of Service
1. The facility/provider will provide services at a minimum of five days
per week. One unit of day treatment is equal to one hour. A minimum
of 30 hours per week of active programming is available.
2. The psychiatric day treatment program utilizes, but is not limited to,
the following clinical operations:
•
Evaluation
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•
Behavioral management
•
Discharge planning
•
Group therapy
•
Multidisciplinary team review
•
Psychoeducation
•
Treatment planning
•
Symptom management
•
Skills training
3. The Psychiatric Day Treatment Program provides structured, goaloriented groups that are focused on symptom management,
understanding the Member’s psychiatric disabilities, improving the
Member’s ability to function in a valued role in the community,
establishing and maintaining stable interpersonal relations, and
practicing health-promoting lifestyles. The program assists Members
in identifying and protecting their legal rights, as well as identifying
and pursuing vocational, educational, and other community and/or
recovery focused interests. The scope of unique services available in
the day treatment program will include, but not be limited to, the
following:
•
Treatment
•
Crisis intervention
•
Case coordination
•
Rehabilitation
•
Enrichment
•
Rights protection
•
Basic support
•
Wellness
•
Referral to self-help
4. The facility/provider ensures that each Member receives a program
orientation at the initiation of services. The information should
include the following: a description of program services, hours of
operation, confidentiality, informed consent, nondiscrimination
provisions, rights and responsibilities, rules of the program, and
telephone number(s) of the appropriate Emergency Services
Program(s) (ESPs).
5. The program provides emergency services 24 hours per day, seven
days per week to all Members enrolled in the program. These services
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are intended to be the first level of crisis intervention whenever needed
by the Member. The program provides these services by phone, and
face- to-face if warranted by the Member’s presentation, during the
program’s operating hours. After hours, the program provides an
emergency phone number that accesses a clinician either directly or
via an answering service. Both during and after operating hours, the
responding clinician provides a brief assessment and intervention by
phone. Based upon this assessment, the provider may refer the
Member, if needed, to an Emergency Services Program (ESP) for an
emergency evaluation. An answering machine or answering service
directing callers to call 911 or the ESP, or to go to a hospital
emergency department (ED), is not sufficient.
Staffing Requirements
1. The facility/provider shall utilize a multidisciplinary staff that includes
a psychiatrist, AND any two of the following licensed clinicians (one
of which must be independently licensed):
•
Psychologist
•
Clinical Nurse Specialist (RNCS)
•
Licensed Independent Clinical Social Worker (LICSW)
•
Licensed Clinical Social Worker (LCSW)
•
Psychiatric Nurse (RN)
•
Licensed Occupational Therapist (OTR)
•
Licensed Mental Health Counselor (LMHC)
•
Licensed Marriage and Family Therapist (LMFT)
•
Certified Rehabilitation Counselor (CRC)
•
Certified Addiction Counselor (CAC)
•
Certified Alcohol and Drug Counselor (CADAC)
•
Registered Psychiatric Rehabilitation Practitioner (RPRP)
•
Registered Expressive Therapists (ATR, MTR, etc.)
•
Registered Recreational Therapists (RTR)
Additional staffing may include allied health professionals or
paraprofessional staff as outlined in CMR 417.432.
2. The facility/program staff will participate in regularly scheduled
supervision and attend training that promotes skill development in the
provision of clinical and rehabilitative services to Members.
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Service, Community, and Collateral Linkages
1.
The provider will develop organizational and clinical linkages with
each of the referral source ESPs and inpatient units, hold regular
meeting as necessary, and communicate with ESPs and inpatient units
on clinical and administrative issues, as needed, to enhance continuity
for Members.
2. For those Members who would benefit from or are currently receiving
medication management and monitoring, the provider facilitates the
referral to or monitors the Member’s ongoing status with the
prescribing authority.
Process Specifications
Treatment
Planning and
Documentation
1.
The facility/provider must ensure that for referrals from psychiatric
inpatient units, Members will be scheduled for an intake appointment
within three business days from the date of discharge.
2.
Members with routine requests for services are offered an
appointment to be scheduled within 10 business days of the date of
the request.
3.
Upon admission, the provider assigns a case coordinator.
4.
The provider shall ensure that assessments are completed, that a
multidisciplinary treatment team has been assigned to each Member
or uninsured DMH client, and that the treatment team has met to
review the assessment and initial treatment plan, by the fifth day of
attendance.
5.
The treatment plan is reviewed by the multidisciplinary team and the
Member after the following:
•
Fifth day of attendance
•
Every 30 days of attendance or 90 calendar days,
whichever comes first
•
After any psychiatric admission that necessitates a change
in the treatment plan
•
When major clinical changes occur
6.
In collaboration with the providers and in the context of the treatment
plan, Members choose a daily schedule that is revised on a periodic
basis to reflect the needs of the Member. The program schedule is
adaptable so that a Member’s changing needs may be addressed.
7.
If public transportation is not readily available, the provider assists
the Member with identifying reasonable transportation alternatives.
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Discharge and
Transfer Planning
1. If the Member is unable or unwilling to attend the program, the
assigned clinician will attempt to contact the Member within 24 hours
and document the attempt, including unsuccessful attempts, within
the Member’s record.
2. The provider will offer Members post-discharge appointments as
follows: within seven business days of discharge for outpatient
services, if necessary; and within 14 business days of discharge for
medication monitoring, if necessary.
3. If the Member terminates without notice, every effort is made to
contact the Member and to provide assistance for appropriate followup plans (i.e., schedule another appointment or provide appropriate
referrals). Such activity is documented in the Member’s record.
When the Member is a DMH identified consumer, DMH is informed
of the termination.
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