Revision 20-0; Effective August 25, 2020

 

The nursing facility (NF) must convene an annual Interdisciplinary Team (IDT) or Service Planning Team (SPT) meeting for a person who is Preadmission Screening and Resident Review (PASRR) positive for mental illness (MI), regardless of whether the person is receiving MI specialized services. The NF is responsible for inviting all IDT members to the annual IDT/SPT meeting.

If the person has refused MI specialized services, the local mental health authority (LMHA)/local behavioral health authority (LBHA) still must attend the annual IDT meeting.

The IDT/SPT members will discuss the specialized services provided by the LMHA/LBHA and review:

  • specialized services the person (or legally authorized representative (LAR) on the person’s behalf) is receiving and/or wants to receive;
  • whether the person is best served in the NF or the community; and
  • whether the person wants to transition to the community. If the person desires an alternative placement, refer to Section 5000, Alternative Placement Considerations.

If the IDT/SPT agrees to the provision of MI specialized services for the person and the person accepts the recommendations, the LMHA/LBHA will review the current authorization for services and make any needed changes. The LMHA/LBHA must then initiate services within 20 days of the IDT meeting.

Within five days upon receiving notification, the LMHA/LBHA must confirm the annual IDT/SPT meeting information in the Long Term Care Online Portal (LTCOP) on the PASRR Comprehensive Service Plan (PCSP) form.

The LMHA/LBHA is confirming the following:

  • Their attendance (in person or by phone) at the IDT/SPT meeting; and
  • Their agreement with all specialized services listed on the PCSP form and agreed to during the IDT/SPT meeting.

 

4100 QMHP-CS Preparation for Annual IDT/SPT Meeting

Revision 20-0; Effective August 25, 2020

 

An LMHA/LBHA Qualified Mental Health Professional-Community Services (QMHP-CS) must prepare to present the IDT/SPT with an update including services provided, the person’s progress or lack thereof, the most current version of the Person-Centered Recovery Plan (PCRP) and changes in the recovery plan that have been made since the last IDT/SPT meeting. The LMHA/LBHA must be prepared to discuss the plan with the team, including what services are planned and what the goals are for the next 180 days or through the end of the current authorization period. The LMHA/LBHA must record an outline of the discussion and provide a copy of the recovery plan in the NF permanent medical record. 

 

4200 Refusal of Mental Illness (MI) Specialized Services 

Revision 20-0; Effective August 25, 2020

 

If an eligible person/LAR does not want MI specialized services at the annual IDT/SPT meeting, the LMHA/LBHA documents the refusal of MI specialized services on the PCSP form and obtains necessary signatures, provides the person/LAR a copy of the completed form provided by HHSC and maintains the original completed form in the person’s record. See Section 3100, Refusal of MI Specialized Services, for additional information on refusal of services.

 

4300 PASRR Evaluation and IDT Meeting Billable Activities

Revision 20-0; Effective August 25, 2020

 

Throughout the MI PASRR process, there are various activities that are billable as PASRR activities. The billable activities begin with the completion of the PASRR Evaluation (PE) and are covered through participation in the IDT meeting.  

The completion of the PE is a billable activity. For claim submissions, the approved rate for PE completion and related activities will be paid at the rate of $12.73 per 15-minute increments, or $50.92 per hour, with a maximum of six hours. PASRR billable activities are defined below.

PASRR Activity

  • Preliminary scheduling call with the facility to arrange assessment;
  • Meeting/coordination with nursing facility (NF) staff;
  • Review of the person's medical records;
  • Face-to-face communication with the person;
  • Communication/coordination with the guardian and collateral contacts;
  • PE results letter to the person. PE evaluators must complete Form 2360, Negative PASRR Evaluation Letter, for a negative PE (which includes Form 2361, PASRR Specialized Services Fair Hearing Request) and when positive, Form 1014, Pre-Admission Screening and Resident Review (PASRR) Evaluation Summary Report, which must be presented to the person/LAR and a signature must be obtained to indicate receipt; 
  • Documentation and entry of evaluation data into the LTC online portal;
  • Participation in the NF IDT for a PASRR-positive person; and
  • Completion of LTC online portal input following the NF IDT meeting.