Mental Health Services: Treatment Procedures

(A) A staff member from one of the disciplines described at 410.475(B) must conduct a comprehensive evaluation of each member prior to initiation of therapy. For members younger than 21 years old, a CANS must be completed during the initial behavioral health assessment before initiation of therapy and be updated at least every 90 days thereafter by a CANS-certified provider, as described in 130 CMR 410.475(B). The CANS is not required during an assessment that is conducted as part of the emergency department screening. (B) The hospital outpatient department must accept for treatment, refer for treatment elsewhere, or both, any member for whom the intake evaluation substantiates a mental or emotional disorder. (C) The hospital outpatient department will ensure that one professional staff member (the primary therapist) assumes primary responsibility for each member. This responsibility will include (1) within four client visits, preparation of a comprehensive written treatment plan that is based on the initial evaluation, incorporates short- and long-term treatment goals, and establishes criteria for determining when termination of treatment is appropriate; 4. Program Regulations (2) ongoing utilization review; (3) review of each case at termination of treatment and preparation of a termination summary that describes the course of treatment and any aftercare program or resources in which the member is expected to participate; and (4) ensuring that a CANS-certified provider, as described in 130 CMR 410.475(B), completes the CANS in accordance with 130 CMR 410.476(A). (D) The hospital outpatient department will make provisions for responding to persons needing services on a walk-in basis. (E) The hospital outpatient department will take appropriate steps to facilitate uninterrupted and coordinated member care whenever it refers a member elsewhere for concurrent or subsequent treatment. (F) Before referring a member elsewhere, the hospital outpatient department will, with the member's consent, send a summary of or the actual record of the member to that referral provider.