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Last Updated:  02/08/2006

Copyright © 2005
Alameda County Behavioral Health Care Services

Mental Health Services

Mental health services are interventions designed to:

• provide the maximum reduction of mental disability, and

• restore or maintain the client’s functioning at the level necessary for learning, development, independent living and enhanced self-sufficiency. 

Services are targeted toward achieving the client’s goals and desired results.  Documentation in the client’s chart should demonstrate the connection between the service provided and the treatment plan.

There are multiple service activity types of that fall under Mental Health Services.  In Exhibit A of your contract, you will make projections about the amount of hours of each of the service activities you expect to provide in this category.

The Service Activities are:  

• Assessment – A clinical analysis of the history and current status of the client’s mental, emotional, or behavioral disorder.  Relevant cultural issues and history may be included where appropriate.  Assessment includes diagnosing the client.  If formalized testing procedures are used, the time used for administration, interpretation, and feedback to the client is all billed as assessment.

• Evaluation – An assessment of the client’s community functioning in several areas, including the living situation, daily activities, social support systems, and health status.  Cultural issues may be addressed where appropriate.

• Collateral – Contact with one or more significant support persons in the life of the client for the purpose of addressing the established treatment goals.  This may include involving significant support persons in service planning and implementation of the plan(s), helping them to understand and accept the client’s condition and impairments, and addressing dynamics that affect the client’s condition.  Family therapy provided on behalf of the client (when the client is not present) should be billed as a collateral service.

• Individual, Family, or Group Therapy – The use of therapeutic interventions to improve the client’s functional impairments.  Interventions focus primarily on symptom reduction and should be consistent with the client’s goals or desired results, as documented in the treatment plan.

• Rehabilitation – May include any of the following, delivered individually or to a group of clients working on similar goals:

  Assistance in restoring or maintaining functional skills, daily living skills, social skills, grooming and personal hygiene skills, meal preparation skills, medication compliance, and support resources.

  Training in leisure activities needed to achieve the client’s treatment goals

  Medication education

  Counseling of the client and/or family related to any of the above

• Plan Development* – Includes any or all of the following: development of plans (treatment, coordination, etc.); approval of plans; verification of medical necessity; and monitoring the client’s progress.

*Plan development is only billed separately if it occurs on a day when other linked services are not provided. For example, during the course of an individual therapy contact, a staff person reviews the client’s treatment plan with her and simultaneously monitors her progress; all of this is billed under individual therapy.  On another day, the staff person meets with her supervisor to discuss the initial treatment plan goals for a new client.  If she has not other billable activities that day, the staff person would bill for plan development.

Case Management/Brokerage Requirements

Case management and brokerage activities are provided by program staff to access needed medical, educational, social, pre-vocational/vocational, rehabilitative, or other types of community services needed by the client.

Service Activities under Case Management/Brokerage include:

• Linkage and Consultation – Identification and pursuit of resources necessary and appropriate to implement the client’s individual services plan.

• Placement Services – Supportive assistance in the assessment and determination of need and in the securing of adequate and appropriate living arrangements. For example: including, but not limited to, the following: locating and securing living quarters and/or finding funding, pre-placement visit(s), related contract negotiations, placement, follow-up, and related supportive contacts with clients or others.

Medication Support Services

Medication support services include prescribing, administering and dispensing of psychiatric medications necessary to alleviate the symptoms of mental illness, as provided by a staff person within the scope of practice of his/her profession.  This category includes: evaluation of the need for medication, evaluation of clinical effectiveness and side effects of medication, obtaining informed consent, mediation education (including discussing risks, benefits and alternatives with the client or significant support persons), and plan development related to the delivery of this service.

Crisis Intervention

Crisis is defined as an unplanned event that results in the client’s need for an immediate response and intervention.  Crisis intervention services are provided only when a quick response time is necessary, and they are limited to stabilization of the presenting emergency, including enabling the client to cope maintaining the client in the community, if possible.  Assessment, evaluation, collateral contact, therapy, and medication support services may be provided in the course of a crisis intervention contact.