Ala. Admin. Code r. 580-2-7-.01

Type Of Certificate

This Alabama Department of Mental Health rule establishes two types of certification for mental health service providers: a general Mental Health Services Provider certificate and a Community Mental Health Center (CMHC) certificate. To qualify as a CMHC, a provider must directly deliver emergency services, outpatient services, consultation and education, and partial hospitalization/day treatment, and must also ensure access to residential services either directly or through a written agreement with another certified provider. Operators must meet specific program description, staffing, and documentation requirements at both the time of application and the first on-site visit for each required service element.

Ala. Admin. Code r. 580-2-7-.01 - Type Of Certificate 

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(1)

 A provider that meets the respective requirements will be issued one of two
 types of certificates depending upon the number and type of services delivered
 by the provider. The criteria listed below will be applied at the time a
 currently certified provider applies for renewal of certification and to an
 initial Application for Certification submitted after the effective date of
 this edition of the standards. 
(a)

Mental Health Services Provider
. A provider will be
 certified as a Mental Health Services provider if one or more covered services
 are provided in compliance with the standards and the requirements for
 certification as a Community Mental Health Center (see (b) below) are not met.
 The services for which a provider seeks certification should be listed on the
 Application for Certification and will be specifically reviewed during the
 on-site visit. The services that a mental health service provider are certified
 to provide will be listed in the cover letter mailed with the
 certificate.

(b)

Community Mental Health Center
. A provider will be
 certified as a Community Mental Health Center (CMHC) if the requirements listed
 below are met. The requirements are designed to assure that any provider
 certified as a CMHC provides the array of services defined below either
 directly or through specific arrangement with another agency/individual to a
 broad array of recipients in an identified service area without regard to age,
 race, sex, and degree of psychiatric disability. The services must be
 coordinated in a manner that assures access to inpatient and residential care
 and to community supports for adults with serious mental illness and children
 and adolescents with severe emotional disturbance. 
 
1.
 The provider must provide the following
 services directly through its employees: 
(i)

 Emergency Services,

(ii)
 Outpatient
 Services,

(iii)
 Consultation and
 Education Services, and

(iv)

 Partial Hospitalization/Intensive Day Treatment/Rehabilitative Day Program in
 order to be certified as a CMHC, and

(v)
 must provide residential services either
 directly through its employees or through agreement with another certified
 provider.

2.
 In addition
 to the specific criteria listed below, the provider must also comply with the
 applicable sections of the program standards for each program element. For each
 required program element under the CMHC certificate, the criteria that must be
 met at the time of initial application and at the time of the first on-site
 visit are specified below.
(i)
 Emergency
 Services. 
(I)
 At the time of application: 
 
I.
 The program description for Emergency
 Services describes how it will be available 24 hours a day, 7 days a week both
 by telephone and face-to-face and how consumers are informed about emergency
 services.

II.
 Policies/job
 descriptions include requirements for Emergency Service staff to be on call 24
 hours a day, 7 days a week.

III.

 The Emergency Service program description includes the following crisis
 intervention services for consumers with serious mental illness or severe
 emotional disturbance.
A.
 Demonstrated
 capacity to gain access to inpatient psychiatric services,

B.
 Capability to assure that consumers who
 are in jail can be evaluated and medications, if any, continued.

(II)
 At the time of the
 site visit:
I.
 There is evidence in consumer
 records and/or other documents that services described in III. above were
 provided.

(ii)
 Outpatient Services. 
 
(I)
 At the time of application: 
 
I.
 Outpatient services are listed on the
 provider's organizational chart.

II.
 The Outpatient program description has
 admission criteria inclusive of all ages, persons with serious mental
 illness/severe emotional disturbance, and persons discharged from inpatient
 psychiatric treatment.

III.

 Specialty services for children and elderly are described.

IV.
 Policies/job descriptions require staff
 treating children and elderly to have the required credentials.

V.
 Specialty services for persons discharged
 from an inpatient psychiatric setting and for persons with a serious mental
 illness/severe emotional disturbance must include the following: 
 
A.
 evaluation and medication monitoring by a
 psychiatrist,

B.
 outreach
 capability to provide services to consumers in their usual living
 situation.

C.
 provision of case
 management services in accordance with the program standards.

D.
 screening for admission to state
 psychiatric hospitals as evidenced by a written agreement with the local 310
 Board (if not a 310 Board), relative to coordination of screening petitions for
 involuntary inpatient commitment for consumers of the CMHC.

VI.
 Follow-up on all missed
 appointments for all high risk consumers including those who: 
 
A.
 have been discharged from psychiatric
 inpatient care within the past 12 months.

B.
 were decompensating at the last
 visit

C.
 are considered potentially
 harmful to self or others,

D.
 have
 a history of aggression, child abuse, or sexual abuse.

(II)
 At the time of the first site
 visit:
I.
 A review of a sample of consumer
 records demonstrates that the services described in the application are
 provided to consumers.

II.
 The
 number of consumers served in each of the five required specialty outpatient
 areas is reasonable and demonstrates that there is a creditable effort to
 provide outpatient specialty services.

III.
 The staff employed in the Outpatient
 program meet the credential requirements for both general and specialty
 services.

(iii)
 Consultation and Education Services 
 
(I)
 At the time of application: 
 
I.
 Application materials describe planned
 consultation and education activities to include both program and consumer
 consultation, and public education.

(II)
 At the time of first site visit: 
 
I.
 Consultation and education activities have
 been provided and documented as described in the application
 materials.

(iv)
 Partial Hospitalization/Day Treatment
 Services
(I)
 At the time of application: 
 
I.
 There is a program description for either
 Partial Hospitalization, Intensive Day Treatment, or Rehabilitative Day Program
 that complies with the respective program standards.

II.
 The proposed staffing pattern conforms to
 the applicable standards in the Mental Illness Program Staff section and the
 respective program standards.

III.

 The organizational chart includes at least one type of day treatment
 service.

(II)
 At the
 time of the first site visit:
I.
 The schedule
 of activities and the consumer records document that the program description
 has been implemented in accordance with the respective certification standards
 for the service.

II.
 Staff meet the
 credential requirements.

(v)
 Residential Services 
 
(I)
 At the time of application: 
 
I.
 There must be available either a written
 program description if residential services are offered directly by the
 provider or a written agreement with another certified residential services
 provider relative to delivery of residential services.

II.
 If the provider is applying to deliver
 residential services directly, the program description and proposed staff must
 conform to the Residential Services standards.

III.
 If the provider proposes to offer this
 service through arrangement with another provider, there must be a written
 agreement that identifies the services to be provided and the manner in which
 they will be coordinated, supervised, and evaluated by the provider.

(II)
 At the time of the site
 visit:
I.
 The consumer records and program
 documentation validate that the program is operating in accordance with the
 program description and the Residential Services Standards.

II.
 There is documentation of the number of
 the provider's consumers that have received residential services through the
 written agreement with another provider. The consumer records and any other
 relevant documents clearly demonstrate coordination, supervision, and
 evaluation of the residential service by the provider. 
 
Author:
 Division of Mental Illness,
 DMH/MR

Notes

Ala. Admin. Code
 r. 
580-2-7-.01

New Rule: Filed October 28,
 1998; effective December 3, 1998. Amended: Filed April 20, 2000; effective May
 25, 2000.

Statutory Authority:

Code of Ala.
 1975
, §
 
22-50-11
.

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