R523-17-9. Minimum Standards of Care and Practice

  (1) Certification or accreditation standards for crisis lines shall include:

  (a) The crisis line providing proof of certification/accreditation from one of the following:

  (i) American Association of Suicidology (AAS),

  (ii) CONTACT USA,

  (iii) Alliance of Information and Referral Systems (AIRS),

  (iv) The Joint Commission,

  (v) Commission on Accreditation of Rehabilitation Facilities (CARF),

  (vi) Council on Accreditation (COA),

  (vii) Utilization Review Accreditation Commission (URAC), or

  (viii) DNV Healthcare, Inc.

  (b) Agencies shall provide State/county licensure, as approved by the division Administrator or designee.

  (c) The telephone crisis service must provide:

  (i) screening and triage,

  (ii) psycho-social support,

  (iii) connection to appropriate resources,

  (iv) follow-up capability to callers as clinically appropriate.

  (d) 24 hour/7 days per week telephone crisis services that are staffed by skilled professionals capable of assessing and making culturally competent, appropriate referrals,

  (e) the use trauma-informed screenings and assessments, and incorporate this information into safety planning, referrals and follow-up interventions,and

  (f) the initiation of mobile crisis services when available that are linked with walk-in crisis service facilities when available.

  (2) Suicide Risk Assessment Standards shall include the National Suicide Prevention Lifeline Suicide Risk Assessment Standards minimum requirements.

  (3) Imminent Risk Policies shall include:

  (a) Crisis lines shall adopt the adoption of the National Suicide Prevention Lifeline Policy for Helping Callers at Imminent Risk of Suicide

  (4) Follow Up Policies that shall include:

  (a) crisis lines maintaining and implementing a policy detailing follow-up procedures including but not limited to:

  (i) safe-care transitions,

  (ii) rapid referrals,

  (iii) caring contacts, and

  (iv) care bridging strategies.

  (b) This policy shall detail how crisis lines will work with community partners and the statewide crisis line.

  (5) Warm Hand Off Policies shall include:

  (a) agencies maintaining written procedure defining and detailing a "warm hand off" process that allows for unique adaptations for each Local Authority crisis service structure, in collaboration with the statewide crisis line.

  (b) This initial procedure for a Warm Hand Off shall read as follows:

  (i) if clinically indicated, provide a warm handoff to Local Authorities providers or other identified providers of care or care managers with an identified health plan. A warm handoff may include:

  (A) a conference call or other direct communication with the Local Authority provider, other provider or care manager to arrange immediate crisis support and scheduling an appointment for follow up support,

  (B) if other needs are expressed by callers then additional resources may be offered to help access local recovery oriented support services as needed,

  (C) coordination with each local authority, regarding preferred communication and resources access as uniquely adapted to each local community, and

  (D) a warm hand off will be done via conference call to facilitate a personal introduction between a Lifeline caller and their local behavioral health treatment providers or care managers, as well as the exchange of pertinent information, to promote the continuity of care.

  (ii) The elements of a successful warm hand off shall include:

  (A) orienting the caller as to what to expect,

  (B) a positive provider to provider communications, and

  (C) provision of accurate information regarding the caller's current condition, treatment and service needs, and safety goals.

  (iii) The steps to initiate a warm hand off include:

  (A) assessing callers for their level of acuity and need,

  (B) offer to provide a person to person introduction to a representative in their local area,

  (C) explain the conference call process to the caller,

  (D) contact the predetermined designated number for provider in their local area,

  (E) communicate the caller's situation and needs,

  (F) introduce the caller and remain on the line as needed to facilitate the conversation, and

  (G) in the event that a warm handoff is clinically indicated and the individual is not able to receive a warm handoff for any reason, a minimum of one follow up "Caring Connection" shall be provided within 72 hours of initial contact, if contact information was able to be collected for the caller.

  (6) Crisis Line Community Collaboration and Coordination Policies shall include:

  (a) a published plan in place that outlines community resources available,

  (b) a collaboratively created plan published that outlines the plan for community collaboration with the following partners at minimum:

  (i) Law Enforcement,

  (ii) hospitals (Emergency Departments),

  (iii) local mental health and substance abuse authorities,

  (iv) schools, and

  (v) any other crisis services in the local community.