1. (a) There shall be an outpatient behavioral health unit which shall provide for the resident’s behavioral health needs as determined by completion of an initial behavioral health interview and a biopsychosocial assessment which results in a behavioral health diagnosis. Referrals for such assessments may be via self-referral made by residents themselves or by any departmental staff member. These referrals shall be triaged accordingly, and for those cases requiring on-going behavioral health treatment, a treatment plan shall be developed and filed in the resident’s medical record.

2. (b) The behavioral health unit shall be sufficiently staffed to include at a minimum:

   1. (1) A full-time New Hampshire licensed administrative clinician who shall:

      1. a. Oversee and supervise the testing operations and determine what types of behavioral health interventions are needed;
      2. b. Conduct staff training, triage referrals to the behavioral health unit, and assist behavioral health staff with individual cases;
      3. c. Provide individual and group counseling and supervise the provision of such counseling by mental behavioral health clinicians; and
      4. d. Review the behavioral health needs of the residents and implement new treatment modalities as indicated;
   2. (2) New Hampshire licensed psychiatric providers who shall provide for the psychiatric needs of the residents and the secure psychiatric unit including prescription of medications, coordination of care between disciplines, and consultation with administration with regard to behavioral health policy development; and
   3. (3) Full-time clinical staff who, at a minimum, shall be qualified under the state personnel system to include, without being limited to, social workers or clinical mental health counselors.

3. (c) The out-patient behavioral health unit shall provide at a minimum the following services:

   1. (1) Documentation and implementation of a treatment plan;
   2. (2) Psychiatric services;
   3. (3) Medication management;
   4. (4) Individual counseling pursuant to RSA 329-B;
   5. (5) Group therapy sessions as appropriate; and
   6. (6) Such other specialized treatment for individuals or groups of resident as needed.
4. (d) Behavioral health services shall be available to all resident regardless of their custody status.
5. (e) Residents who are transferred to the restricted housing settings such as the special housing unit (SHU) shall be screened prior to being placed in a cell. The behavioral health unit shall conduct a suicide risk assessment and suitability review of the resident’s placement. If the behavioral health unit’s staff is not on-site, nursing staff shall conduct the assessment within health services. All staff shall complete appropriate clinical documentation recording the assessment and outcome of the assessment in the resident’s health record. If the resident presents a risk as a result of the assessment, alternative housing arrangements shall be made to secure the individual for their safety.

6. (f) Residents who are prescribed psychotropic medications or are diagnosed with a severe mental illness (SMI) that are housed in the SHU shall have clinical appointments scheduled at least every 14 business days that shall include at a minimum the following:

   1. (1) Status examination as follows:

      1. a. Appearance;
      2. b. Interaction;
      3. c. Speech;
      4. d. Mood/Affect;
      5. e. Thought process;
      6. f. Thought content;
      7. g. Suicidality; and
      8. h. Violence;
   2. (2) A review of their medications and any reported side-effects for triaging to psychiatric providers;
   3. (3) A subjective statement of each resident’s current emotional status;
   4. (4) An assessment of diagnosis/es with reflection of psychiatry’s perspective, if available in the health record;
   5. (5) The treatment plan shall be updated which shall include referral to a case manager, assignment to group therapy, triage to medical staff, or other individual specific goals based on the clinical appointment; and
   6. (6) A monthly report of these clinical appointments to track compliance to the 14-day standard and treatment plan development which shall be reviewed by the director of medical and forensic services for compliance to the standards.
7. (g) The department shall provide a psycho-social skill development program in restricted housing settings at all facilities. Such programs will be provided in consultation with the bureau of behavioral health. These shall operate in quarterly cycles with at a minimum of 4 offerings a year for residents referred in these settings by the behavioral health staff;
8. (h) The correctional staff assigned to restricted housing settings shall be provided with specific training at a minimum of quarterly on topics related to the treatment and supervision of individuals with behavioral health issues; and
9. (i) The correctional staff assigned to restricted housing settings shall conduct at minimum 30-minute rounds on individuals housed in theses settings on psychotropic medications or diagnosed with a severe and persistent mental illness.

10. (j) There shall be therapeutic communities as follows for those residents:

    1. (1) Who because of significant functional impairment due to their documented behavioral illness are unable to successfully live in the general population;
    2. (2) Who are diagnosed with substance use disorders; or
    3. (3) Who are diagnosed with other behavioral health disorders.

11. (k) The therapeutic communities shall be sufficiently staffed to include at a minimum:

    1. (1) A full time administrator who shall:

       1. a. Oversee the clinicians managing the therapeutic communities to ensure proper procedures are followed regarding admission, treatment, and transition of residents;
       2. b. Manage the process of evaluating and triaging those residents’ referred for therapeutic communities services; and
       3. c. Supervise the collection of quality improvement data and participate in the development of quality improvement benchmarks; and
    2. (2) Clinical staff to meet the treatment needs of those receiving treatment in the therapeutic communities including but not limited to of recreational therapy, psychological services, special education, behavioral health therapy, medical care, safety, and psychiatric interventions.

12. (l) Residents admitted to the therapeutic community shall receive a complete evaluation of their psychiatric needs including at a minimum:

    1. (1) A complete psychiatric evaluation;
    2. (2) A comprehensive clinical assessment; and
    3. (3) An assessment of skills required to successfully navigate in their housing unit.
13. (m) Above mentioned assessments shall result in the development of a master treatment plan that specifically addresses the individual’s clinical needs.

Source. (See Revision Note at chapter heading for Cor 500) #12793, eff 5-25-19