Ancillary Services

Definition Ancillary services are services that are not available through existing contracted mental health services for youth. The funding for such services is limited and closely monitored to assure that disbursement is completed in the most clinically appropriate and fiscally responsible manner.

Supportive services that facilitate mental health treatment delivery as outlined in the CSP for time-limited interventions that are not available through existing contracted services. Examples include: transportation services, interpretive services, specific clinical services that are not available through contracted providers and special community programs or classes. The ancillary service must clearly support the youths improved functioning in their home/community and/or prevent the likelihood of movement to a higher level of care.

Services Offered

Admission Criteria All of the following criteria must be met:

1. The identified youth meets at least one (1) of the Service Eligibility criteria for CAMHD (as described in General

Standards, Section B, Access & Availability), is registered with a Branch and has an assigned CC; and

2. The clinically appropriate requested services/items are required to allow the youth to meet the goals identified in the CSP and improve his/her functioning in the home/community or likely prevent the movement to a higher level of care. The services are procured by the CC after all other resources are exhausted.

Initial Authorizations The need for clinically appropriate services/items is identified by the CSP team and documented in the CSP, approved by the Branch Clinical Lead and procured by the CC.

Unit = One (1) Dollar

Re-Authorization The approval of the amounts greater than 5000 units requires the Division Chief’s approval.

Unit = One (1) Dollar

Continuing Stay Criteria All of the following criteria are met as determined by clinical review at least quarterly:

1. All admission criteria continue to be met;

2. Services/items are being provided as indicated in the CSP and documented in progress notes and in plan reviews;

3. There are regular and timely assessments and documentation of youth/family response(s) to services. Timely and

appropriate modifications are made to services and plans as needed;

4. Goals, objectives, and discharge planning as related to

ancillary funded services/items are reviewed at least quarterly; 5. The youth/family continues to be actively involved in treatment

interventions and treatment planning; and

services/items.

Discharge Criteria Ancillary funded services/items are terminated when one (1) of the following criteria are met:

1. The youth is no longer eligible for CAMHD services. As part of discharge, the CC will help coordinate transfer to appropriate treatment services in the least disruptive manner possible; 2. The youth is no longer eligible for services/items - (i.e., does

not meet admission criteria);

3. The clinical review determines that services/items are no longer needed; or

4. Services/items are obtained through alternative sources.

Service Exclusions 3. No educational or basic health services are to be provided through ancillary services.

4. Ancillary services are not stand-alone services. Ancillary services must augment and compliment other intensive mental health treatment services.

Staffing Requirements

1. If the ancillary service is a direct mental health service, then only a professional practitioner credentialed by CAMHD shall be allowed to perform this service.

2. All professionals providing direct services to youth and families shall have minimally met initial credentialing requirements for provisional appointments through submittal of required documents and satisfactory verbal verification of primary sources prior to date of hire.

INDIVIDUAL PRACTITIONER CREDENTIALING INFORMATION:

Qualified Mental Health Professional (QMHP):

Must be a current Hawaii-licensed psychiatrist; board certified by the American Board of Psychiatry and Neurology (ABPN); and board certified or board eligible in Child and Adolescent Psychiatry. QMHP Psychiatrists in hospital-based settings must be ABPN board certified in Child and Adolescent Psychiatry;

OR

A Clinical or School Psychologist with a current Hawaii license/certification in psychology;

OR

A certified Advanced Practice Registered Nurse (APRN) as a Psychiatric Clinical Nurse Specialist with a current Hawaii license/certification;

OR

A Hawaii licensed Clinical Social Worker (LCSW);

OR

A Hawaii licensed Marriage and Family Therapist (LMFT);

OR

A Hawaii licensed Mental Health Counselor (LMHC) at such time inclusion is incorporated into the State Plan Amendment and Contractors are notified by CAMHD.

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Educationally Supportive Intensive Mental Health Services Ancillary Service

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Clinical Operations

If providing direct mental health services, then the professional is bound by all professional licensing requirements, professional ethics as well as CAMHD practice guidelines.

Documentation

1. Provider must submit Ancillary Provider Registration Form to the CC prior to the initiation of services if providing mental health treatment services.

2. Original receipts for services/item must be provided as appropriate.

3. Providers of direct mental health services, please see Section I General Standards for additional documentation requirements:

• F. Service Planning:

ƒ Mental Health Treatment Plan including transition, crisis and discharge planning; ƒ Discharge Summary;

• N. Maintenance of Service Records: ƒ Progress Notes;

• P. Minimum Reporting Requirements: