471 NAC 35-007. PSYCHIATRIC RESIDENTIAL REHABILITATION

007. PSYCHIATRIC RESIDENTIAL REHABILITATION. The following psychiatric residential rehabilitation service requirements apply. 007.01 PSYCHIATRIC RESIDENTIAL REHABILITATION. The psychiatric residential rehabilitation program is designed to: (A)Increase the beneficiary's functioning so that they can eventually live successfully in the residential setting of their choice, based on their capabilities and resources; and (B)Decrease the frequency and duration of hospitalization. 007.02 PURPOSE. The psychiatric residential rehabilitation program provides skill building in community living skills, daily living skills, medication management, and other related psychiatric rehabilitation services as needed to meet individual beneficiary needs. These facilities are integrated into the community, and every effort is made for these residences to approximate other homes in their neighborhoods. 007.03 PROGRAM COMPONENTS. The program provides: (A)COMMUNITY SKILLS. Community living skills and daily living skills development; (B)MEDICATION. Beneficiary skills development for self-administration of medication, as well as recognition of signs of relapse and control of symptoms; and (C)TRANSPORTATION. Skill building in the usage of public transportation or assistance in accessing suitable local transportation to and from the psychiatric residential rehabilitation program. 007.04 LICENSURE REQUIREMENTS. The program must be licensed as a residential care facility, domiciliary, or mental health center by the Department . 007.05 STAFFING REQUIREMENTS. The program must have the appropriate staff coverage to provide services for beneficiaries needing to remain in the residence during the day. 007.06 BED LIMITATION. The maximum capacity for this facility must not exceed 16 beds. 007.07 SUPPORTIVE SERVICES. The program provides the following supportive services for all active beneficiaries: referrals, problem identification and solution, and coordination of the residential rehabilitation program with other services the beneficiary may be receiving. 007.08 REFERRALS FOR REHABILITATIVE PSYCHIATRIC SERVICES. Referrals for rehabilitative psychiatric services will be directed to Nebraska Medicaid or its designee. The referral must include documentation that establishes: (A)The beneficiary's eligibility for Nebraska Medicaid; and (B)How the beneficiary meets the definition of serious and persistent mental illness specified in this chapter. 007.09 ELIGIBILITY FOR REHABILITATIVE PSYCHIATRIC SERVICES. To be eligible for rehabilitative psychiatric services, the beneficiary must be eligible for Nebraska Medicaid, meet the definition of severe and persistent mental illness, and be authorized by Nebraska Medicaid or its designee for specific services. 007.10 SERVICE NEEDS ASSESSMENT AND REHABILITATIVE PSYCHIATRIC SERVICE RECOMMENDATIONS. All beneficiaries determined eligible for rehabilitative psychiatric services must be assessed and have rehabilitative psychiatric service recommendations developed by a referring provider according to specified protocols.