PURPOSE: This rule provides standards for psychosocial rehabilitation programs operated as part of a community psychiatric rehabilitation program.

1. (1) The activities of the psychosocial rehabilitation program shall focus on—

   1. (A) Development of behaviors and abilities that will allow the client to return to activities appropriate to his/her age and based on the client’s assessed needs;
   2. (B) Development of behaviors and abilities that will allow the client to fully participate in community living;
   3. (C) Prevention of extended psychiatric hospitalization(s);
   4. (D) Establishment and improvement of an individual’s desire or motivation to maximize independence;
   5. (E) Development of a personal support system; and
   6. (F) Provision of meaningful activity which is appropriate to the age and level of functioning and interest of the client.

2. (2) The psychosocial rehabilitation program shall be accredited by the Council on Accreditation of Rehabilitation Facilities or licensed as a day program by the department under 9 CSR 40-1.015–9 CSR 40-10.155 inclusive.

   1. (A) In those instances in which certification standards are more restrictive than licensure standards, the certification standards shall prevail.
   2. (B) The director of the psychosocial rehabilitation program shall be a mental health professional and shall have two (2) years of relevant work experience.

3. (3) The psychosocial rehabilitation program shall implement policies and procedures for intake screening, referral, and client assignment.

   1. (A) Intake policies and procedures shall define procedures for referral of persons ineligible for psychosocial rehabilitation services.
   2. (B) Maximum client waiting time from initial face-to-face contact to intake screening is ten (10) working days or sooner if clinically indicated.
   3. (C) The intake screening shall determine the client’s need of psychosocial rehabilitation, functional strengths and weaknesses, and transportation needs.
   4. (D) Full assessment and development of a psychosocial rehabilitation program plan shall occur within thirty (30) days of admission to the program.

4. (4) The psychosocial rehabilitation program shall establish policies and procedures to implement and maintain documentation of measurable progress in the following key services:

   1. (A) Training/rehabilitation in community living skills;

   2. (B) Prevocational training/rehabilitation either directly or through subcontracts, according to individual client need, including, at a minimum, but not limited to, the following:

      1. 1. Interview and job application skills;
      2. 2. Therapeutic work opportunities; and
      3. 3. Temporary employment opportuni-

ties; and

1. (C) Development of personal support systems through a group modality.

1. (5) The psychosocial rehabilitation program may provide illness management and recovery services that promote physical and mental wellness, well-being, self-direction, personal empowerment, respect, and responsibility in individual and group settings. The maximum group size for Psychosocial Rehabilitation Illness Management and Recovery shall not exceed eight (8) participants; however, if there are other curriculum-based approaches that suggest different group size guidelines, larger group sizes may be approved by the department. Services shall be person-centered and strength-based and include, but are not limited to, the following:

   1. (A) Psychoeducation;
   2. (B) Relapse prevention; and
   3. (C) Coping skills training.
2. (6) Individual professional psychosocial rehabilitation may be provided utilizing a skillsbased approach to address identified behavioral problems and functional deficits relating to a mental disorder that interferes with an individual’s personal, family, or community adjustment.
3. (7) Group professional psychosocial rehabilitation may be provided utilizing a skills-based approach to address identified behavioral problems and functional deficits relating to a mental disorder that interferes with an individual’s personal, family, or community adjustment with maximum group size of one
4. (1) professional to eight (8) individuals.
5. (8) Psychosocial rehabilitation for youth may be provided as a combination of goal-oriented and rehabilitative services provided in a group setting to improve or maintain the youth’s ability to function as independently as possible within the family or community. Services shall be provided according to the individual treatment plan with an emphasis on community integration, independence, and resiliency. Hours of operation shall be determined by the individual providers based on capacity, staffing availability, geography, and space requirements but shall be no more than six (6) hours per day.
6. (9) The community psychiatric rehabilitation
7. (CPR) provider shall provide or arrange transportation to and from the psychosocial rehabilitation program, as well as to various sites in the community, to provide off-site training/rehabilitation in realistic settings.
8. (10) The psychosocial rehabilitation program shall provide regular client access to facilities and equipment necessary to provide opportunities for training and rehabilitation in daily living skills, including at a minimum, those activities associated with meal preparation and laundry.
9. (11) The psychosocial rehabilitation program shall provide off-site services on a regular basis as part of the structured plan of activities for training/rehabilitation of community living skills.
10. (12) The psychosocial rehabilitation program shall provide or arrange for services on evenings and weekends, as required, to effectively address the rehabilitation needs of the program clients.
11. (13) The psychosocial rehabilitation program shall implement policies and procedures to provide for the participation of clients, client 9 CSR 30-4

family members, and client advocates (with client agreement) in the planning, development, and evaluation of the psychosocial rehabilitation program’s activities.

AUTHORITY: section 630.655, RSMo 2000.* Original rule filed Jan. 19, 1989, effective April 15, 1989. Amended: Filed Dec. 13, 1994, effective July 30, 1995. Amended: Filed Dec. 1, 2011, effective June 30, 2012.

*Original authority: 630.655, RSMo 1980.