R523-18-5. Minimum Guidelines and Standards of Care

  (1) Mobile crisis services provide a timely in-person response to a crisis in the community. Mobile crisis services shall collaborate with local and statewide crisis line services, and any additional crisis response services, including the stabilization and mobile response services if available.

  (2) When a MCOT is dispatched from the statewide crisis line, the statewide crisis line staff shall provide whenever possible the:

  (a) the name of individual in crisis,

  (b) their date of birth,

  (c) the presenting problem as demonstrated through the individual's current behaviors),

  (d) the location of the individual needing services,

  (e) any history of violence and/or substance use,

  (f) the presence of any weapons and/or dogs in the house, and

  (g) the need for a coordination plan to include police assistance, and/or family's willingness to helping coordinate services while accounting for all relevant safety and security issues, so the MCOT can provide a timely face to face response.

  (3) When law enforcement requests response from a MCOT, and is staying on scene, it is important to provide as rapid as a response as possible which may mean, responding to the crisis with limited information.

  (4) A MCOT must have the capacity to:

  (a) intervene wherever the crisis occurs,

  (b) serve individuals unknown to the system,

  (c) coordinate multiple simultaneous requests for services and,

  (d) work closely with police, EMS, Fire, dispatch, crisis hotlines, schools, hospital emergency departments, and other related agencies.

  (5) A MCOT must operate 24 hours per day, 7 days per week, and 365 days per year in providing community-based crisis intervention, screening, assessment, and referrals to appropriate resources.

  (6) In screening the individual in crisis, the MCOT must collect at least the following information:

  (a) identifying information,

  (b) the chief complaint/presenting problem,

  (c) acute medical concerns and chronic health conditions, and

  (d) current healthcare providers.

  (7) The MCOT must administer an ongoing assessment, if clinically indicated by the initial screening, that shall include:

  (a) any imminent danger to the individual in crisis through potentially lethal means of harm to one's self or others.

  (b) risk for suicide using the Columbia Suicide Severity Rating Scale (C-SSRS)or another empirically validated instrument,

  (c) the individual's emotional status and imminent psychosocial needs,

  (d) individual strengths and available coping mechanisms,

  (e) resources that can increase service participation and success, and

  (f) the most appropriate and least restrictive service alternative for the individual, and the referral mechanisms and procedures to access services.

  (8) Following the assessment, if there is risk for harm to self or others, the MCOT shall engage the person to establish a crisis response plan using:

  (a) Crisis Response Planning (CRP),

  (b) Stanley Brown Safety Plan, or

  (c) another evidenced based safety plan/crisis prevention practice.

  (9) If clinically indicated access ER or other crisis receiving facility to address ongoing safety concerns and for further evaluation.

  (10) A MCOT must be staffed by skilled and licensed mental health professionals.

  (11) A MCOT must understand the emergency civil commitment process as described in Section 62A-15-629, and one of the members must be either a Designated Examiner or Mental Health Officer to facilitate civil commitment should that be the indicated course of action for the safety of the individual, family or the community.

  (12) A MCOT will preferably utilize Certified Peer Support Specialists and Family Resource Facilitators, in conjunction with a Mental Health Therapist when deploying for mobile crisis outreach.

  (13) A MCOT shall respond to individuals in the community who are in crisis with the goal of resolving the crisis in the least restrictive manner and setting, including:

  (a) reducing inpatient treatment admissions and Emergency Department visits if appropriate,

  (b) increasing jail diversions, and

  (c) reducing law enforcement involvement while maintaining public safety.

  (14) A MCOT shall collaborate with stakeholders involved in the crisis service delivery system and partner to resolve service delivery concerns.

  (15) MCOT providers shall have a published plan in place that outlines triage policies and coordination of crisis response services with community stakeholders.

  (a) The plan shall address community collaboration with the following partners at minimum:

  (i) Local Mental Health and Substance Abuse Authorities,

  (ii) SMR providers,

  (iii) local law enforcement,

  (iv) fire departments,

  (v) dispatch,

  (vi) hospital emergency departments,

  (vii) schools,

  (viii) EMS,

  (ix) Department of Human Services agencies, and

  (x) other social service partners, including health plans and other crisis services in the local community.

  (16) The MCOT provider shall enter into MOU's with each Local Mental Health and Substance Abuse Authority operating a crisis line in their region, and the Statewide Crisis Line. The MOU shall include the following elements at a minimum:

  (a) data sharing process between Statewide Crisis Line, Local Authority and MCOT provider including data on number of callers from region MCOT serves,

  (b) mobile deployments from the Statewide Crisis Line,

  (c) a clear procedure for coordination between the Statewide Crisis Line and MCOT provider, for deploying MCOT services for individuals in need of MCOT services who have called into the Statewide Crisis Line,

  (d) data and a process for warm hand offs between Statewide Crisis Line, MCOT, and Local Authorities to support individuals in ongoing services; and

  (e) procedures for case consultation on services, high utilizers, and collaboration.