Date: April 21, 2020
To: Mobile Crisis Response - Designated Service Area Providers
Re: Mobile Crisis Response Services Update – COVID-19
This notice provides updated COVID-19 guidance to Screening, Assessment, and Support Services (SASS)/Mobile Crisis Response (MCR) - Designated Service Area essential providers and will extend only until the termination date of the COVID-19 public health emergency. This guidance is intended to reinforce the State’s mission to provide the most effective services to individuals and families experiencing psychiatric crises while also protecting the safety of essential SASS/MCR staff during the public health emergency.
HFS continues to encourage providers to use materials available through the Centers for Disease Control (CDC) and the Illinois Department of Public Health (IDPH) as part of their internal education of staff.
Initial Crisis Intervention via Phone or Video
After receiving a referral from CARES, the SASS/MCR provider will contact the individual in crisis, or the individual who reported the crisis to CARES, via phone or video to provide initial Crisis Intervention to attempt to stabilize the crisis. If the SASS/MCR provider is able to stabilize the individual, a Crisis Screening via the Illinois Medicaid – Crisis Assessment Tool (IM-CAT) will not be required. Staff should bill for their time completing telephonic or videoconference intervention as Crisis Intervention, on-site.
If the initial Crisis Intervention via phone or video does not result in a stabilization of the crisis, a Crisis Screening will be conducted.
If the SASS/MCR staff are unable to have direct access to the individual (e.g., the individual is at a location that the staff is not allowed to access, the family does not want in-person contact by MCR staff), or the SASS/MCR provider assesses the situation as clinically unsafe for clients and themselves, the staff may, under these circumstances, conduct the Crisis Screening via telephone or video. Staff should bill for their time completing the telephonic or videoconference screening as Crisis Intervention, on-site.
If the individual is accessible, is requesting an in-person screening and an in-person screening can be completed with reasonable safety precautions (e.g., use of PPE, CDC recommended social distancing, use of alternative safe locations, etc.) the SASS/MCR provider will complete, or will arrange for a partner provider to complete, a face-to-face crisis screening at the location of the crisis, or an alternative safe setting away from the home to ensure the safety of the individual and staff. Staff should bill for completing the in-person Crisis Screening as Mobile Crisis Response, off-site.
If the SASS/MCR provider reaches the location of the crisis and is only able to interact with the individual in crisis via phone or video, as a reasonable safety accommodation, that is allowable as part of the Mobile Crisis Response, off-site service event.
Psychiatric Hospitalization, if recommended
If the individual requires inpatient psychiatric services, SASS/MCR staff will need to coordinate admission procedures with the hospital to determine if face-to-face, phone or video should be used to ensure that neither the individual nor others are put at further risk for COVID-19 in the Emergency Department (ED) areas of the hospital. If the individual is showing signs of COVID-19, this information must be communicated to the hospital. The hospital’s admitting physician may also use telehealth to complete the admission assessment, if necessary, to prevent exposure of the SASS/MCR staff and the individual to COVID-19 in the ED.
Follow up Services
Whether the individual is hospitalized or is deflected and referred for community services, SASS/MCR staff should engage the individual in on-going telehealth services, either through initiating an Integrated Assessment and Treatment Plan, or through connecting the individual with their existing clinical staff who can engage the individual in additional telehealth follow-up services.
The telehealth follow-up services should be provided frequently enough to address the situation or symptoms that resulted in the crisis contact. Community Mental Health Centers/Behavioral Health Clinics should utilize telehealth to provide follow-up services after a crisis situation and to engage existing clients through telehealth as much as possible, especially during the public health emergency.
Questions regarding this notice may be directed to the Bureau of Behavioral Health via telephone at 217-557-1000 or via email at HFS.BBH@illinois.gov.
Interim Medicaid Administrator