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4.consent for treatment has been withdrawn; or
5.the youth and/or family have not benefitted from MST, despite documented efforts to engage, and there is no reasonable expectation of progress at this level of care despite treatment.

AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 35:

Chapter 253.Services

§25301.Covered Services

A.The components of MST services include:

1.an initial assessment to identify the focus of the MST intervention;
2.therapeutic interventions with the individual and his or her family;
3.peer intervention;
4.specialized therapeutic and rehabilitative interventions to address all areas seen as contributing to an individual’s delinquency including, but not limited to:
a.substance abuse;
b.sexual abuse; or
c. domestic violence; and
5.crisis stabilization.

B.The duration of MST intervention is typically three to six months. Weekly interventions may range from three to 20 hours per week and may be less as a case nears closure.

C.Services are primarily provided in the home, but may also be provided at school and in other community settings.

AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 35:

§25303.Service Exclusions

A.MST services are comprehensive of all other mental health services, with the exception of psychiatric/psychological evaluation or assessment and medication management. These may be provided and billed separately for a recipient receiving MST services.

B.MST shall not be billed in conjunction with the following services:

1.mental health rehabilitation (MHR) services other than medication management and assessment;
2.partial hospitalization;
3.day treatment;
4.residential services, including Therapeutic Foster Care;
5.respite care; or
6.any other outpatient therapies (individual, family and group).

AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 35:

Chapter 255.Provider Participation

§25501.Provider Qualifications

A.In order to enroll to participate in the Louisiana Medicaid Program as a Medicaid provider of MST services, agencies must be licensed to provide such services by MST Services, Inc. of Mount Pleasant, South Carolina, or any of its approved subsidiaries.

B.An MST agency must be a behavioral health/substance abuse provider organization which:

1.is a legally recognized entity in the United States and qualified to do business in Louisiana; and
2.meets the standards established by the Bureau of Health Services Financing or its designee.

C.Providers must document team coordination on each case at least once per week. Weekly standardized MST documentation will be required and the provider must allow the bureau to access its MST report data.

AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

HISTORICAL NOTE:Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 35:

§25503.Staffing Requirements

A.Clinical services and supervision must be provided by licensed behavioral health practitioners in accordance with their respective licensing board regulations. All practitioners must hold an unrestricted Louisiana license.

B.Staffing for MST services shall be comprised of no more than one-third Bachelors level staff and, at a minimum, two-thirds licensed masters level staff. MST team members must include, at a minimum:

1.a masters level Clinical Supervisor who is an independently licensed behavioral health professional; and
2.licensed masters, non-licensed masters or bachelors level behavioral health staff able to provide 24 hour coverage, seven days per week.
a.Licensed masters level behavioral health practitioners may perform all therapeutic interventions and supervision of non-licensed staff.
b.Non-licensed master’s level and bachelors level behavioral health practitioners may not provide clinical supervision and must be supervised by a licensed Masters level practitioner for all clinical activities.
i.Bachelor’s level staff must have a degree in social work, counseling, psychology or a related human services field and must have at least three years of experience working with the target population (youth and their families).
3.All college degrees must be from a nationally accredited institution of higher education as defined in Section 102(b) of the Higher Education Act of 1965, as amended.

C.All clinical staff is required to participate in and complete a prescribed five day MST introductory training and subsequent quarterly trainings.

D.MST direct service staff to family ratio shall not exceed one to six.

E.Clinical Supervision. Weekly supervision shall be provided by an independently licensed masters level behavioral health practitioner who is MST trained. This supervision, following the MST supervisory protocol, shall be provided to team members on topics directly related to the needs of MST individuals and their families on an ongoing basis.

1.A minimum of one hour local group supervision per week and one hour of telephone consultation per week with an MST systems supervisor is required.

AUTHORITY NOTE:Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

Louisiana Register   Vol. 34, No. 10   October 20, 2008

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