IRTS: Step System

ARROWHEAD HOUSE EAST

Intensive Residential Treatment Service

Step System – January 2014; updated February 2016

Prior to advancing to the next step, recipients are responsible to schedule a meeting with their Primary Mental Health Practitioner to discuss their engagement in treatment and the appropriateness of a step increase.  Step increases will be determined by the entire Treatment Team at a Clinical Meeting each Thursday at 2:00pm.  Each recipients step level will be posted on the bulletin board in the office after each Clinical Meeting.

A recipient may move forward or backward in the Step System as determined by functional level, participation level, progress, and individual safety concerns.  In cases of relapse, recipients will be kept on Step 1 for a minimum of 30 days from the date of relapse.

STEP 1 – Admission Date – 14 days (2 weeks) - Integration into Treatment Process

 

a.       Recipient will meet with the:

·         Treatment Director to complete an Immediate Needs Assessment and develop a 24 Hour Treatment Plan, and necessary financial paperwork.

·         Clinical Director to complete required assessments and determine whether you want family or significant others involved in your treatment.  If so, a release will be signed to communicate with them and an initial meeting will be scheduled.

·         Mental Health Rehab Worker to review the Recipient Handbook and sign necessary releases to communicate with other providers and support resources.

·         Assigned Primary Mental Health Practitioner to complete required assessments and develop an Individual Treatment Plan (ITP) and Individual Abuse Prevention Plan (IAPP).

·         Registered Nurse to complete a physical examination within 72 hours of admission to ensure that you receive prescribed medications and necessary medical and psychiatric care.   Medical/Psychiatric appointments will be made through the Registered Nurse.  Whenever possible, appointments will be made during hours that do not interfere with groups. 

·         Dietary Mental Health Rehab Worker to complete the Kitchen/Cooking - Independent Living Skills Assessment.

·         Evening or Housekeeping Mental Health Rehab Worker to complete the Housekeeping - Independent Living Skills Assessment.

b.      Participation and engagement in treatment, including attendance at all assigned groups, meeting for daily 1:1 rehabilitation encounters, performing assigned kitchen duties, and maintaining housekeeping of room.

c.       Participation in the Initial Staffing with Treatment Team (comprised of Case Manager, Arrowhead House Staff, Parole Officer (if applicable), and any other support systems involved in treatment).

d.      There are no off grounds privileges unless accompanied by staff.  Special circumstances, such as death or illness of a family member, may be considered.   To have a special circumstance considered, recipients must complete a special request form with the Clinical Director or Treatment Director- either may approve the request.

e.       Visits by family and friends are allowed when it does not interfere with group times or during the staff clinical meeting.  Evening visits are allowed from 7:00pm-9:00pm.  Visitors must sign in and out at the office.  Visits will occur only in the dining room, smoking room, or grounds of the property. 

f.       Staff provides transports both ways for approved appointments.

Recipients requiring multiple prompts to attend groups, take medications, maintain their room cleans and laundry, etc., may be required to remain on Step 1 until they are able to comply with the expectations of treatment.   

STEP 2 – Day 15 – Day 29 (the next 2 weeks) - Building on Treatment

 

a.       30 Day Review – meet with assigned Primary Mental Health Practitioner to complete required updates to the Inidividual Treatment Plan (ITP) and Individual Abuse Prevention Plan (IAPP).  An updated Functional Assessment will also be done.

b.      Participation and engagement in treatment, including attendance at all assigned groups, meeting for daily 1:1 rehabilitation encounters, performing assigned kitchen duties, and maintaining housekeeping of room.

c.       Participation in the 30 Day Staffing with Treatment Team (comprised of Case Manager, Arrowhead House Staff, Parole Officer (if applicable), and any other support systems involved in treatment).

d.      With prior approval, recipients may have off grounds privileges in order to attend appointments for housing, Social Security, etc.  Arrowhead House will provide transportation for medically necessary appointments to those on Step 2.  Arrowhead House East will transport to approved appointment; client will be responsible to get transportation back to the facility, or utilize the assistance of the peer support specialist to learn the bus system.

e.       With prior approval, recipients may have off grounds privileges in order to attend outside meetings, such as AA. Arrowhead House will provide transportation for these meetings.  To request privileges for outside meetings while on Step 2, recipients must complete a special request form with their Mental Health Practitioner which will be reviewed at the weekly clinical meeting for Team approval.   Arrowhead House East will transport to approved meeting; client will be responsible to get transportation back to the facility, or utilize the assistance of the peer support specialist to learn the bus system.

f.       All requests for transports must be made prior to the Community Meeting each morning. 

g.       Visits by family and friends are allowed when it does not interfere with group times or during the staff clinical meeting.  Evening visits are allowed from 7:00pm-9:00pm.   Visitors must sign in and out at the office.  Visits will occur only in the dining room, smoking room, or grounds of the property.

 

STEP 3 – Day 30 – Discharge - Stabilization of Treatment

 

a.       60 Day Review – Recipients will meet with their assigned Primary Mental Health Practitioner to complete required updates to their Treatment Plan (ITP) and Individual Abuse Prevention Plan (IAPP).  An updated Functional Assessment will also be done.

b.      Participation and engagement in treatment, including attendance at all assigned groups, meeting for daily 1:1 rehabilitation encounters, performing assigned kitchen duties, and maintaining housekeeping of room.  

c.       Participation in the 60 Day Staffing with Treatment Team (comprised of Case Manager, Arrowhead House Staff, Parole Officer (if applicable), and any other support systems involved in treatment).   In an effort to provide the best possible treatment, Clients, Agencies, and Family Support are asked to complete satisfaction surveys as part of this staffing.

d.      Recipients may have off grounds privileges in order to attend appointments for housing, Social Security, etc.  

e.       Recipients may have off grounds privileges in order to attend outside meetings, such as AA, up until 10:00pm, providing they have completed all assignments and completed their daily 1:1 daily encounter.

f.       Recipients on Step 3 are expected to get to and from their appointments and meetings.  Two bus passes are available for sign out in the staff office. 

g.       When recipients do leave the grounds, there is a sign out sheet in the office that must be completed giving the exact location, purpose of leaving, and expected time of return.  To sign out with a location of “downtown” is not enough.  Residents are expected to return at or before the expected time.  If recipients are unable to do that for any reason they will call and notify AHE Staff.

h.      Visits by family and friends are allowed when it does not interfere with group times or during the staff clinical meeting.  Evening visits are allowed from 7:00pm-9:00pm.  Visitors must sign in and out at the office.  Visits will occur only in the dining room, smoking room, or grounds of the property.

i.        Overnight requests will be considered after 60 days of treatment.  To request an overnight visit, recipients will complete a special request form with their Mental Health Practitioner which will be reviewed at the weekly clinical meeting for Team approval.

j.        At 75 days, or 15 days prior to discharge, participation in the Discharge and Aftercare Plan is expected, along with a review of the Individual Abuse Prevention Plan (IAPP).

 

Arrowhead House reserves the right to modify the step system on a case by case basis to adhere to each recipient’s individualized treatment plan.  All modifications will be requested through the special request form and must be approved by the Clinical Director.   Arrowhead House is committed to your Treatment – if you have any concerns or special circumstances, please consult with us!