1. (a) A CCBHC must conduct outreach activities to engage underserved individuals and populations, with an emphasis on the special population list also known as the "Most in Need" list that is determined and supplied to the CCBHC by the ODMHSAS. These activities must be services reported through the Medicaid Management Information System (MMIS). The CCBHC must have dedicated staff who do not carry a caseload. The CCBHC must have policies and procedures to describe how outreach and engagement activities will occur to assist consumers and families to access benefits and formal or informal services to address behavioral health conditions and needs.
2. (b) Facility records will identify which staff members are responsible for specific elements of outreach and engagement.
3. (c) To the extent possible, the facility should make reasonable efforts to provide transportation or transportation vouchers for consumers to access services provided or arranged for by the facility.
4. (d) To the extent allowed by state law, facility will make services available via telemedicine in order to ensure consumers have access to all required services.
5. (e) The facility will ensure that no individuals are denied services, including but not limited to crisis management services, because of an individual's inability to pay and that any fees or payments required by the clinic for such services will be reduced or waived to enable the facility to fulfill this assurance. The facility will have a published sliding fee discount schedule(s) that includes all services offered.
6. (f) The facility will ensure no individual is denied behavioral healthcare services because of place of residence or homelessness or lack of a permanent address. Facility will have protocols addressing the needs of consumers who do not live within the facility's service area. At a minimum, facility is responsible for providing crisis response, evaluation, and stabilization services regardless of the consumer's place of residence and shall have policies and procedures for addressing the management of the consumer's ongoing treatment needs. In addition, for those consumers who are homeless, the CCBHC must attempt to obtain at least two contact phone numbers for persons of the consumer's choice who know how to reach the consumer in the consumer's record, and/or a location where the consumer is most likely to be found, and/or a location to find a person of the consumer's choice likely to know where the consumer is located.
7. (g) The facility shall report to the Department any individual who is denied services and the reason for the denial. Reporting shall be completed in a form and manner prescribed by the Department.
8. (h) Each CCBHC must meet the following for the provision of crisis services:
9. (1) CCBHCs are responsible for the provision of 24-hour in-person crisis care to all individuals in need of crisis services within their catchment area. Services must include the following: triage crisis response, crisis intervention, crisis assessment, crisis intervention plan development, and linkage and referral to other services as applicable, with the ability to serve all ages within each catchment area.
10. (2) Each CCBHC shall ensure the availability of urgent recovery clinics (URCs) and crisis stabilization units (CSUs) in accordance with nationally recognized crisis data (such as NASMHPD Crisis Resource Needs data), state crisis resource needs data, and regional sustainability data. At a minimum, each CCBHC must maintain the total number of crisis receiving chairs for all counties within its catchment area, as designated by the NASMHPD "CrisisNow" calculator, through strategic URC and CSU locations in the catchment area. For Tulsa County and Oklahoma County, the total receiving chairs must be maintained between all CCBHCs/CBSCCs that serve the county. If necessary to meet the minimum in either county, ODMHSAS may require one CCBHC entity to add URC and/or CSU sites or chairs/beds at its discretion.
11. (3) CCBHCs shall ensure individuals' travel time to a crisis facility meets the following:
12. (A) Individuals living within a rural county of the CCBHC's catchment area shall not have to travel more than seventy-five (75) miles to reach a URC or CSU.
13. (B) Individuals living within an urban county of the CCBHC's catchment area shall not have to travel more than twenty-five (25) miles to reach a URC or CSU.
14. (C) In lieu of a certified URC or CSU, a CCBHC may utilize a formal partnership with a hospital facility/emergency department to provide appropriate facility-based crisis care in accordance with OAC 450:23 to meet the above requirements, as permitted by state and federal regulations.
15. (D) A CCBHC may request an exception to the requirements in (A) and (B) above by providing written justification for the exception, subject to approval by ODMHSAS.
16. (4) Any CCBHC intending to close any URC or CSU must first obtain written approval from ODMHSAS prior to closing the facility.
17. (5) Each CCBHC shall submit to ODMHSAS no later than October 1, 2025 a written Crisis Framework that will ensure the above is met. This document must describe the following:
18. (A) How the CCBHC will ensure timely access to the full continuum of crisis services to all individuals in its catchment area;
19. (B) The number, bed capacity, and location of URC and CSU facilities the CCBHC will maintain;
20. (C) The farthest distance an individual in the catchment area would need to travel to access a URC or CSU and the travel time required;
21. (D) How the CCBHC will ensure timely transportation for any individual in the catchment area in need of crisis services;
22. (E) The number of mobile crisis teams operating in the catchment area, including total number of staff, total number of LBHPs, and average response time (time from the call to in-person interaction with the individual) for mobile crisis services;
23. (F) How the CCBHC interfaces with law enforcement, first responders, and each emergency department and inpatient hospital in its catchment area to ensure appropriate crisis and other behavioral health services are provided to reduce unnecessary emergency/inpatient stays; and
24. (G) How the CCBHC will monitor access to the full continuum of crisis services throughout its catchment area utilizing measurable outcomes.
25. (6) CCBHCs seeking to modify their crisis continuum as described in its Crisis Framework shall submit to ODMHSAS a formal proposal that identifies how the recommended adjustments will ensure continued or enhanced access to behavioral health crisis services in accordance with SAMHSA’s National Guidelines for Behavioral Health Crisis Care. Modifications shall be subject to approval by ODMHSAS and shall not be implemented prior to approval.
26. (7) ODMHSAS shall identify key measurable outcomes to be reported at regular intervals by each CCBHC (no less than once per year) to monitor access to crisis services within each catchment area. At its discretion, ODMHSAS may require the implementation of modifications to a CCBHC's Crisis Framework based on these outcomes.
27. (i) Compliance with this Section shall be determined by a review of policies, consumer records and facility fee schedule.

Added at 33 Ok Reg 964, eff 9-1-16

Amended at 34 Ok Reg 1777, eff 10-1-17

Amended at 39 Ok Reg 1938, eff 9-15-22

Amended at 41 Ok Reg, Number 22, effective 9-1-24

Amended at 42 Ok Reg, Number 20, effective 9-1-25