Acute Partial Hospitalization Programs (APHPs) for Children/Youth with Serious

Acute Partial Hospitalization Programs (APHPs) for Children/Youth with Serious Emotional Disturbance or Adults with Serious Mental Illness or Partial Hospitalization Programs (PHPs) for Adults or Children/Youth with Substance Use Disorders A. Acute Partial Hospitalization Programs (APHPs) – SED/SMI and Partial Hospital Hospitalization Programs (PHPs) – SUD provide medical supervision, nursing services, structured therapeutic activities, and intensive psychotherapy (individual, family, and/or group) to people who are experiencing a period of such acute distress that their ability to cope with typical life circumstances is severely impaired. These programs are designed to provide an alternative to inpatient hospitalization. Service content may vary based on need but must include close observation/supervision and intensive support with a focus on the reduction/elimination of acute symptoms. APHPs may be provided to children/youth with serious emotional disturbance or adults with serious and persistent mental illness. PHPs may be provided to children and youth or adults with substance use disorders. For people with substance use disorders, Level 2.5 PHPs can be utilized as a step-down from an inpatient or residential level of care or as an initial level of care as determined by an ASAM Level of Care Placement assessment. B. APHPs/PHPs must be a part of a written comprehensive plan of Crisis Stabilization and Community-Based Support Services offered to people participating in the program. At a minimum, services include family intervention, Targeted Case Management, medication monitoring, Crisis Response Services, and Community Support Services. The program must be designed to assist people in making the transition from acute inpatient services, and/or serve as an alternative to inpatient care. C. There must be written policies and procedures implemented for providing an APHP/PHP that include at a minimum: 1. Admission criteria and procedures. These procedures must require that a physician conduct an admission evaluation and certify that the service is required to reduce or prevent the need for inpatient services. 2. Procedures requiring documented medical supervision and follow along with on-going evaluation of the medical status of the person. 3. Procedures requiring documented support services for families and significant others. 4. Procedures implementing and documenting discharge criteria to include follow-up planning. D. Programs must include at each service location a full-time director who plans, coordinates, and evaluates the service. E. Program personnel must meet the following minimum requirements: 1. At least one (1) employee with a minimum of a master’s degree in a mental health or related field must be on-site for six (6) or fewer people for which the service is certified to serve. The employee can be the on-site Service Director if they are actively engaged in programmatic activities with people during all service hours. 2. At least one (1) employee with a minimum of a master’s degree in a mental health or related field and at least one (1) employee with a minimum of a bachelor’s degree in a mental health or related field when seven (7) through 12 participants are served. 3. At least one (1) employee with a minimum of a master’s degree in a mental health or related field, at least one (1) employee with a minimum of a bachelor’s degree in a mental health or related field, and at least one (1) support employee when 13 through 18 participants are served. F. Programs must provide adequate nursing and psychiatric services to all people served. At a minimum, these services must be provided weekly (and more often if clinically indicated). Provision of these services must be documented through an implemented written procedure carried out by the agency provider or through contractual agreement. G. Medical supervision and nursing services must be immediately available and accessible to the service during all hours of operation. H. Persons served must receive a minimum of 20 hours of service per week. Programs can be operated seven (7) days per week, but must at minimum: 1. Operate at least three (3) days per week; 2. Operate at least four (4) hours per day, excluding transportation time; and 3. Be available 12 months per year. I. Programs must be designed for a maximum number of 18 people. People placed in a Level 2.5 Partial Hospitalization level of care must be assessed every seven (7) calendar days to ensure level of care appropriateness. For people with substance use disorders, the length of stay will be determined based on the results of an ASAM LOC Assessment. J. The service provider must maintain a daily schedule of therapeutic activities to include individual, group, family, and other activities that are designed to provide intensive support to the people in the service and reduce acute symptomology. K. The service location must have sufficient space to accommodate the full range of service activities and services and must provide a minimum of 50 square feet of multipurpose space for each person served. L. Programs must be located in their own physical space, separated from other substance use services, and impermeable to use by other services/service locations during hours-of- service operation.