1 / 30

Behavioral Health Rehabilitation

Behavioral Health Rehabilitation. Quest MHSA, LLC - Tutorial. 1.

liz
Download Presentation

Behavioral Health Rehabilitation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Behavioral Health Rehabilitation • Quest MHSA, LLC - Tutorial 1

  2. The following information is not sanctioned by any state or federal agency, you as a licensed or certified and credentialed clinician are ethically and legally responsible for following state/federal regulations in the services you provide.

  3. Medicaid Policy - OAC 317:30-5-240 - 249 Outpatient BH Services: are covered when provided under a full BioPsychoSocial Assessment and Individualized Treatment Plan conducted by a licensed BH professional. The Tx Plan is developed to treat the identified mental health and/or substance abuse disorder(s), with the goal of improvement of functioning, independence, and well-being of the member. The member must be able to actively participate, have sufficient cognitive abilities, communication skills, and short term memory to benefit from treatment.

  4. Behavioral Health Rehabilitation Specialist • BA or MA degree from an accredited college/univ; AND • Completion of the ODMHSAS BHRS training; OR • Cert. Psychiatric Rehab Practitioner credential; OR • Certification as an Alcohol and Drug Counselor; OR • Licensed as a RN w/DMHSAS BHRS credential; OR • BHRS prior to 7/1/10 w/DMHSAS credential on file.

  5. Psycho-Social Rehab Services - (PSR) PSR is the process of restoring community functioning and well-being of an individual who has a psychiatric and/or substance abuse disorder. Rehabilitation work seeks to effect changes in a person’s environment and in a person’s ability to deal with his/her environment, so as to facilitate improvement in symptoms or personal distress.

  6. Individual • Performed Face 2 Face with only the client and the BHRS • sessions may include a client’s family/support system in order to focus on the individuals goals/objectives. • Ages 6 and up, younger will need prior approval

  7. Group • Performed F2F with only the BHRS and a group of clients • Staffing Ratios: • 1 BHRS to 14 adults (18-up) • 1 BHRS to 8 children (6-17)

  8. PSR Policy • Community or Office Based • Travel time to and from PSR is NOT compensable. • SoonerRide (SR): • Ind PSR, SR is covered • Group PSR, SR is NOT-covered, unless the client has special transportation needs for wheelchair, etc.

  9. PSR Policy • Breaks, meals and times when the client is unable/unwilling to participate are NOT compensable, & must be deducted from billed time. • CMS federal 8-min rule: when you do 8 minutes minimum, then you round up to a 15 min unit. • If you do less than 8 min, then you do not bill that unit. • The BHRS must be present interacting, teaching, and/or supporting the learning objectives of the member for the entire claimed time. 9

  10. Daily Limits • Individual PSR - • 6 units/1.5 hours per day maximum allowed • Clinical standard is 1 hr • Time must be age/developmentally appropriate. • Group PSR - • 24 units/6 hrs adults, 16 units/4 hrs children • Group clinical standard is 1 - 1.5 hrs per subject/topic

  11. PSR - 8 main Areas • Psychiatric • Social • Vocational/Educational • Daily Living Skills • Financial • Community/Legal • Health/Medical • Housing

  12. Psychiatric • Symptom Management • depression • anxiety & panic attacks • ADHD • Anger • trauma

  13. Vocational/Educational • NOT-Tutoring • Coping Skills • Job Application/Resume’ • Interviewing • Motivation • Customer Service

  14. Social • Relationships • Family • Boundaries • Communications • Community Integration

  15. Daily Living Skills • Hygiene • Food Planning/Preparation • Cleaning • Safety • Scheduling/Time Mgmt

  16. Community/Legal • Accessing Resources • Being an Active Part of one’s community • Presentation skills • Setting up Supports • Taking Charge of Records

  17. Financial • Budgeting • Bill Paying/Utilities • Setting up a Bank Account • Tax Preparation • Saving

  18. Health/Medical • Nutrition • Exercise • Meditation/Relaxation • Medical/Psych Appt Mgmt • Symptom Mgmt • Schedules/Logs

  19. Housing • Housing • Furniture • Safety • Appliances • Maintenance

  20. Do’s & DON’TS • Don’t do the daily maximum allowed hours just because the policy says you can. • Don’t do the daily maximum in order to fatten your wallet. • Do what is clinically right for the client.

  21. Do’s & DON’TS -contd. • Don’t take a kid to an activity and bill for the whole time. • Don’t take a group of kids to an activity, go off w/ one kid to do Ind Rehab and leave the rest unattended. • Do take a kid to an activity, and bill only the F2F time that you spend teaching a skill or observing the client practicing that skill. • Don’t treat a kid age 0-5 unless you have approval thru Quest’s Clinical Director and proper oversight by LBHP

  22. Do’s & Don’ts-contd. • Don’t go sit in a child’s class and bill the whole time. • Do sit in a child’s class to observe, then do some instruction w/ the child when allowable, focused on what will help them to maintain better in school and with their peers.

  23. Do’s and Don’ts - Contd. • Don’t - “processing feelings” • Don’t - “tutoring” • Don’t - work without the supervision/consultation of the therapist or Quest’s Clinical Director on cases • Don’t – “mentoring”or“coaching” • Don’t - “parent skills training” (unless the parent is covered) • Do - “teaching” • Do - “practicing” • Do - “role playing” • Do - monitoring how the client is doing on their Tx Plan goals • Do - coordinate with the therapist on client care

  24. Case Management • Do Case Management to assist a client in accessing needed resources in their community to live independently. • Don’t do CM and bill it as PSR! Go get your CM certification so you can bill for this!!

  25. Progress Notes(PNs) • Focus - What objective(s) were worked on in session? What skills were taught/learned/practiced? • Intervention - what specific behaviors/suggestions did you do to promote change? • Response - what did the client report? how did the client respond to the intervention(s)? what did they practice? • Plan - what is the client going to work on between now and next session?

  26. Group PNs • Write 1 note for each child in group, majority will be similar, but the client response (and possibly homework) will be individual to the client. • If you do more than 1 group in a day: • You will do PNs for each separate group topic • Example: • 1st group, 1 hour on Anger Mgmt, • 2nd group, 1 hour on Personal Hygiene

  27. PSR 75% Rate Schedule • Individual PSR • $8.84 per 15 min • Group PSR • Adult (18 and over) • $2.04 per 15 min • Children (0-17) • $2.92 per 15 min

  28. BHRS Safety Rules • Quest takes the safety of our contractors very seriously. • Please do not ever feel that you have to enter or stay in a situation that you do not feel safe, leave immediately, call the main office and we’ll reschedule your appointment at a safelocation. • Read “The Quest Contractor Safety Manual” at www.questmhsa.com

  29. BHRS Resources • Clinical Director - Alisa Longnecker, alongnecker@questmhsa.com • Quest Website - www.questmhsa.com, Click on Resources • Center for Psychosocial Rehab - http://cpr.bu.edu/ • Technical/Websites/Computer/Logins - • Paul Marcum, pmarcum@questmhsa.com • Billing/Payroll • Marla Maple, mmaple@questmhsa.com

  30. THE END

More Related