I.      PURPOSE

To define roles of staff members when a crisis or an emergency occurs with Support, Inc. consumers.

II.     POLICY

A.           It is the policy of Support, Inc. to respond professionally and appropriately to all after hours on call and crisis situations with consumers in care. Support, Inc. shall respond to after hours and emergency situations with consumers and in accordance to the consumer’s crisis plan.

III.    POLICY INTERPRETATION

The Executive Director or designee shall responsible for the interpretation of this policy.

IV.    PROCEDURE AUTHORITY

The Executive Director or designee shall establish procedures to fully implement compliance with this policy.

V.     HISTORY AND REFERENCE

Adopted 11/22/2004, amended 12/13/2005

VI.    PROCEDURES

A.  Support, Inc. shall provide consumers with a Crisis Emergency contact number at admissions.

B.     On call Communication Plan consists of the emergency contact number that may be communicated in the following manner: voice mail, web site, consumer handbook and/or upon admissions. The communication plan will be provided to LME emergency services upon request, and via other correspondence deemed necessary.

C   .    Business hours (determined as 8:00am-5: 30pm, Monday through Friday)

1.            Primary CM will manage crisis with supervisory and clinical support. We will use a tier system that provides supervisory support in handling during and after hour crisis issues. If the primary therapist cannot be reached and there’s need for clinical intervention Support, Inc. will utilize Qualified Professionals to assist w/ crisis.

2.            First step is to determine needs and necessary supports. Refer to the consumers crisis plan. All At-Risk consumers will have a crisis prevention plan.

3.            Determine crisis need for de-escalation and face-to-face intervention. Conduct assessments to determine supports necessary to deescalate. Supervisors are responsible for assisting staff.

4.            If components of crisis plan are not available (i.e. primary therapist, clinical support) then Support, Inc. will continue on with assessment phase to determine need by using a Qualified Professional.    

5.            Evaluation/assessment by primary therapist and/or Qualified Professional must occur prior to pursuing inpatient treatment. Primary therapist or CM is not available then responsibility falls to the designated on call QMHP with clinical support and administrative support.

6.            Coordinate and link consumer to identified services. This includes going over safety contract if appropriate.

7.            On call contact is responsible for communicating issues with primary CM and Supervisor that business day or by the next business day.

8.            Follow-up with consumer and/legal guardian to ensure stability and safety and maintain continuity of care. 

D.        After Hours (determined as all hours outside regular business hours). The steps outlined above must also be followed for after hour crisis. Below identifies responsibility for handling after hour calls:

1.      First Responder is designated by Service Coordinator and/or Director and in accordance with service. The first responder is responsible for assessing crisis.

2.      Review crisis plan to determine steps/interventions identified for consumer.

3.      Supervisor contacts on call staff necessary.

4.      Face to face de-escalation with consumer. Assessment if necessary. Clinical Support is available to complete an evaluation/assessment if necessary. 

5.      Assessment/evaluation-determine need for therapeutic intervention and level of care.

6.      Clinical Director needs contacted by Supervisor or designated QP completing evaluation when evaluation determines level IV placement.

E.        The LME (Crisis Emergency Services-CES) shall be contacted prior to any potential state admissions. LME is the single portal entry for all state institutions.

F.         Consumers admitted to inpatient facilities must receive appropriate care coordination. Care coordination includes admissions, discharge planning and treatment team planning. Primary CM must follow-up with consumer as required by state guidelines and to ensure safety and stability. Furthermore, there must be a treatment team meeting within 72 hours of level IV placement.

G.        County commitment procedures must also be followed.