This regulation establishes standards for Therapeutic Individualized Rehabilitation Services (TIRS), a time-limited (not to exceed 7 days per event), community-based mental health program for children and adolescents ages 5–18 with Serious Emotional Disturbance. Operators must maintain an approved program description covering admission and discharge criteria, required services (clinical assessment, case management, family support, skills training, and mentoring), and supervision requirements (master's-level supervisor with 2 years post-master's experience and weekly face-to-face consultation). The program must be authorized by the Alabama Department of Human Resources and ensure effective communication access for consumers who are deaf, hard of hearing, or limited English proficient.
View official sourceAla. Admin. Code r. 580-2-9-.25 - Therapeutic Individualized Rehabilitation Services (TIRS) State Regulations Compare (1) The program description is approved by the board as specified in 580-2-9-.08 (10)(b) and is consistent with the provisions of this section. The program description shall include all of the following components: (a) A description of the nature and scope of the program that includes at a minimum the provision of services as specified in this section and as indicated by individual consumer need. (b) A description of the geographic service area for the program. (c) Admission criteria that include at least the following: 1. Presence of Serious Emotional Disturbance. 2. Age range from 5-18 years. 3. IQ of 70 or above. 4. Must have been screened and assessed for TIRS. 5. Must be receiving active case management in addition to TIRS. 6. Clearly documented need to sustain and maintain the child's placement in the home and community and prevent out of home placement for the consumer. 7. Admission is approved by a Licensed Independent Practitioner as specified in 580-2-9-.06 (9)(g)6. (d) Discharge/transfer criteria and procedures shall be considered for discharge from the program under any one of the following criteria: 1. The TIRS service time limit has been reached (not to exceed 7 days per event). 2. The treatment goals have been met to the extent that TIRS services are no longer needed. 3. The TIRS is unable to meet obvious, suspected or expressed needs of the consumer and/or their family. 4. Transfer or referral to a different program outside of TIRS will occur when it is determined that the transfer will better meet the needs of the consumer and their family. Transfer shall be considered under the following conditions. (1) The child or adolescent and family are in need of more intensive services that the TIRS can provide. (ii) The consumer is determined to be in need of less intensive services than those provided by TIRS. (iii) The consumer and family become eligible for a similar service elsewhere and prefer it. (2) The following services must be delivered within the program: (a) A clinical assessment that demonstrates the need for this level of care. (b) The needs determination must be based upon the approved DMH assessment tools. (c) The consumer must be currently involved with community mental health services and receiving case management services at a minimum. (d) The TIRS provider may provide age appropriate family support and education, parent training, basic living skills, socialization opportunities, mentoring services, and advocacy as needed. (e) TIRS shall be documented as a needed service on the Treatment Plan. (3) The individual and the home have to be authorized to do so by the Alabama Department of Human Resources. (4) Consumers who are deaf, hard of hearing, or limited English proficient shall have effective communication access to these services provided by: (a) Staff fluent in the consumer's preferred language, or (b) A qualified interpreter or staff working with consumers who are deaf shall have at least an Intermediate Plus level on the Sign Language Proficiency Interview. (5) TIRS are supervised by a staff member who has a master's degree and 2 years of post-master's clinical experience. The record shall document a minimum of one hour of face-to-face staffing consultation with the supervisor weekly as documented in the consumer record and shall include any recommendations made. (6) TIRS shall reflect the following characteristics and philosophy: (a) TIRS is an hourly or daily care for children or adolescents which is time-limited (not to exceed 7 days per event). (b) TIRS are intended to sustain the child and maintain the child's placement in the home and community. (c) TIRS can include, but is not limited to, social skills, leadership skills, mentoring services, behavioral skills, and socialization opportunities. (d) TIRS shall provide a community based mental health service that will increase the consumer's ability to build and establish adaptive social and emotional relationships. (e) TIRS shall expand the consumer's continuum of care by providing services to families and child-serving systems to maintain children and adolescents in their local communities. (f) TIRS shall provide an individualized mentoring activity which will increase the social, emotional, and psychological well-being of the consumer thereby reducing caregiver stress relate to the day-to-day responsibilities of caring for a consumer with severe emotional disturbance Notes Ala. Admin. Code r. 580-2-9-.25 New Rule: Filed June 14, 2010; effective July 19, 2010. Author: Division of Mental Illness, DMH Statutory Authority: Code of Ala. 1975 , § 22-50-11 . State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare. No prior version found. State Regulations Toolbox