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Community Psychiatric Rehabilitation Program (CPRP)

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This Medicaid-funded program provides intensive, community-based rehabilitation services for severely mentally ill adults who meet CPRP eligibility criteria. Ongoing assessment, coordination and communication within the treatment team is essential to the successful delivery of CPRP services.

The psychiatrist is the key treatment team member and contributes:
  • Significant and substantive involvement to guide the service delivery experience for the treatment team
  • Evaluation and approval of admission into the program on the basis of:
    • History
    • Review of systems
    • Mental status exam
    • Diagnostic formulation (using DSM-IV-TR)
Diagnoses That Qualify for CPRP Services
Individuals with a diagnosis and who meet the other CPRP admission criteria are eligible for CPRP services:

Schizophrenia and other Psychotic Disorders
  • Paranoid -- 295.3X
  • Disorganized -- 295.1X
  • Catatonic -- 295.2X
  • Undifferentiated -- 295.9X
  • Residual -- 295.6X
  • Schizophreniform Disorder -- 295.4X
  • Schizoaffective Disorder -- 295.7X
  • Delusional Disorder -- 297.1X
  • Psychotic Disorder, NOS -- 298.90
Bipolar Disorders
  • Single manic episode --296.0X
  • Most recent episode, manic -- 296.4X
  • Most recent episode, depressed -- 296.5X
  • Most recent episode, mixed -- 296.6X
  • Bipolar II disorder -- 296.89
Depression and Mood Disorders
  • Major depressive disorder, recurrent -- 296.3X
Personality Disorders
  • Obsessive-Compulsive Disorder -- 300.30
  • Borderline Personality Disorder -- 301.83
Anxiety Disorders
  • Generalized anxiety disorder -- 300.02
  • Panic disorder with agoraphobia -- 300.21
  • Panic disorder without agoraphobia -- 300.01
  • Agoraphobia without panic disorder -- 300.22
  • Social phobia -- 300.23
  • Post-Traumatic Stress Disorder -- 309.81
Children Only
  • Bipolar disorder, NOS -- 296.80
  • Major depressive disorder, single episode -- 296.2x
  • Reactive attachment disorder of infancy or early childhood -- 313.89
CPRP Disability Criteria for Admission
The extent of emotional, cognitive, behavioral and social impairment on functional skills is another criterion necessary for admission to CPRP. There must be clear evidence of serious impairment of behavioral functioning as evaluated by a psychiatric interview:
  • Social Role Functioning -- The ability to sustain the role of family member, neighbor, tenant, worker, student, parent and others
  • Daily Living Skills -- The ability to engage in personal care (safety and self-care, personal hygiene) community living (handling individual finances, using community resources, performing household chores, decision-making skills) and activities appropriate to the individual's age and social role functioning
A master's level clinician completes a full psychosocial assessment prior to admission to CPRP. A treatment plan also is completed. This defines the measurable goals and the type of services to be provided. The psychiatrist's impressions and recommendations regarding the stabilization and rehabilitation objectives are a requirement of the program. The psychiatrist should discuss impressions and recommendations directly with the community support worker (CSW) to include the assessment and treatment plan. Our goal is to provide the right service in the right amount at the right time.

Upon admission into CPRP, a CSW is assigned to the client. The CSW is responsible for:
  • Monitoring the client's level of functioning and response to treatment
  • Conducting home and community visits in between physician visits to assess and intervene as needed, and to promote diversion from hospitalization, if appropriate
  • Working closely with contract providers, physicians, other health-care professionals, and the client's support system to coordinate services and to assist the client to reach their own optimal level of functioning in their community
  • Providing direct supports or arrange for necessary services to sustain clients in the housing, relationships, work and leisure settings of their choice
The CSW contacts the client's psychiatrist quarterly to discuss clinical issues affecting client safety and response to treatment. The psychiatrist's recommendations regarding services offered, their frequency and any health matters are important to the level of physician involvement. This information is integrated into the quarterly review for the treatment plan. Contract providers receive copies of all updated treatment plans and quarterly reviews. Resulting revisions to the treatment plan objectives and interventions are made.

Program Certification and Reimbursement
To be certified as a Community Psychiatric Rehabilitation Program, the agency and contract psychiatrists must adhere to the programs established standards. The Division of Medical Services -- of the Department of Social Services -- has defined the clinical situations whereby reimbursement is allowed.
  • A psychiatrist and CSW may meet with a client at the same time

  • At the one year anniversary of admission to the Community Psychiatric Rehabilitation Program and each Annual Individual Treatment and Rehabilitation Plan thereafter, the physician is contacted by the CSW to provide clinical involvement significant to the evaluation and treatment plan; this includes the content of the evaluation, the clinical impressions and the resulting recommendations
Changes in a CPRP Client's Diagnosis
If a client is receiving CPRP services and you assess a change in their Axis I diagnosis, a medical and psychiatric assessment form and mental status exam form must be completed. Contact the medical director before changing the diagnosis and forms.

 


    
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