Psychosocial Rehabilitation Program Services

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1 Psychosocial Rehabilitation Program Services 2013

2 Overview Objectives Definitions What it is not What it is Who can provide What to focus on Populations of Service Documentation Requirements 2

3 Objectives Define what Psychosocial Rehabilitative Services (PSR) is according to Medicaid guidelines. Define what PSR is not; Understand recipient eligibility requirements for PSR; Create documentation for PSR as an activity based service. Information obtained from the Medicaid Community Behavioral Health Coverage and Limitations Handbook 3

4 What is Psychosocial Rehabilitative Services (PSR)? The goal of this service is to assist the recipient to compensate for or eliminate functional deficits and interpersonal and environmental barriers created by their disabilities, and to restore social skills for independent living and effective life management. Activities designed to achieve that goal may include: Development and maintenance of necessary daily living skills; Food planning and preparation; Money management; Maintenance of the living environment; 4

5 What is Psychosocial Rehabilitative Services (PSR)? Cont. Training in appropriate use of community services; Development of cognitive and socialization skills necessary for functioning in a work environment; Completion of a work readiness assessment; Job development and on the job training; and Job matching and job support. 5

6 Difference Between PSR and Counseling This activity differs from counseling and therapy in that it concentrates less upon the reduction of symptoms and more upon restoring functional capabilities. PSR focuses on skill building rather than therapeutic processing of feelings, symptoms or behaviors. 6

7 Who can provide PSR services? PSR services can be provided by the following individuals: Certified behavioral health technician under the supervision of a bachelor s level practitioner; Bachelor s level practitioner under the supervision of a master s level practitioner; or Substance abuse technician, or certified addictions professional. 7

8 What is the focus of PSR? Helping the recipient to develop basic skills for daily living, such as: Developing budgeting and money management skills; Developing healthy and supportive social relationships; Maintaining a healthy living environment; Understanding and recognizing symptoms of illness; Understanding importance of medication compliance; and Finding and maintaining a source of income. 8

9 Who is eligible to receive PSR? Individuals are considered appropriate for PSR services if they are exhibiting: Psychiatric, behavioral or cognitive symptoms; Addictive Behaviors; or Clinical conditions of sufficient severity to bring about significant impairment in day-to-day personal, social, pre-vocational and educational functioning. 9

10 Documentation Requirements A daily service note that describes what activities the rehabilitation counselor completed to enhance/support the recipient s skills of: Daily medication use; Independent living and social skills; Housing; Pre-vocational and transitional employment training; Social support and networking; Food planning, Money and life management; and 10

11 What to include in a daily note Specific problem/behavior/skill deficit identified; Specific service and description of what activities the rehabilitation counselor did to enhance/support the recipient s skills; Original, dated, legible, signature and credential or functional title of the individual rendering the service. 11

12 Documentation Requirements, cont. A monthly progress note that reflects how the services are linked to the goals and objectives of the recipient s treatment plan, and describes the recipient s progress or lack thereof relative to the treatment plan. 12

13 What to include in a monthly note Dates of service; How services are linked to treatment plan goals and objectives ; Description of the recipient s progress relative to treatment plan; Original, dated, legible, signature and credential or functional title of the individual rendering the service is provided. 13

14 Skill building vs. therapy PSR is a skill building service that focuses on restoring a recipients activity level. Documentation needs to focus on the activity the counselor is facilitating that increases a recipients skill base rather than processing feelings. It differs from therapy in that it is used to educate, teach and increase a recipient s activity level to improve their functioning in home, work, or social setting. 14

15 Counselor s focus PSR counselors facilitate groups and document the how in the activity they are providing: What activity did the counselor facilitate? How did the recipient respond to the activity? What did the recipient learn that relates back to the treatment plan? What benefit did they gain in participating in the activity that relates to the goals/objectives outlined in the treatment plan? 15

16 Daily Note Example Specific problem, behavior or skill deficit for which service is being provided: Managing mental health symptoms. (This is the group topic. How does it relate to an identified problem for this recipient?) Topic: Daily living skills (Very broad identification of a possible skill deficit.) Staff Intervention: Staff facilitated group on identifying mental health diagnosis with video aid. (What was the video? Did staff lead a discussion?) 16

17 Daily Note Example cont. Client: Did participate as evidenced by: Client watched video aid. Client: Did make progress toward objectives being addressed. (How was progress measured? How did you know?) 17

18 Revised Daily Note Example Specific problem, behavior or skill deficit for which service is being provided: Client has difficulty functioning in the community on a daily basis due to presence of auditory hallucinations. Topic: Symptom Management Staff Intervention: Staff facilitated a group discussion following a video identifying common symptoms that group members may experience related to their mental health diagnosis. 18

19 Revised Daily Note Example Client Participation : Client watched the informational video and actively engaged in the follow-up discussion. Client Response: The client was able to share with the group how symptoms of her illness impact her ability to function independently in the community. She accepted feedback from the group and was able to identify techniques presented in the video that may be helpful, such as making sure she takes her medication as prescribed and notifying her doctor of any increase in symptoms. 19

20 Q&A THANK YOU 20

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