In addition to the definitions in 50-5-101, MCA, the following definitions apply to this subchapter:

(7) "Comprehensive school and community treatment program (CSCT)" means a comprehensive, planned course of community mental health outpatient treatment provided in cooperation and under written contract with the school district where the youth attends school. The program must be provided by a licensed mental health center with an endorsement under ARM 37.106.1955, 37.106.1956, 37.106.1960, 37.106.1961, and 37.106.1965.

(1) The CSCT program must be able to provide the following services, as clinically indicated, to youth as outlined in the individualized treatment plan (ITP):

• (a) individual, group and family therapy;

• (b) behavioral intervention;

• (c) other evidence and research-based practices effective in the treatment of youth with a serious emotional disturbance;

• (d) direct crisis intervention services during the time the youth is present in a school-owned or operated facility;

• (e) a crisis plan that identifies a range of potential crisis situations with a range of corresponding responses including physically present face-to-face encounters and telephonic responses 24/7, as appropriate;

• (f) treatment plan coordination with substance use disorder and mental health treatment services the youth receives outside the CSCT program;

• (g) access to emergency services;

• (h) referral and aftercare coordination with inpatient facilities, psychiatric residential treatment facilities, or other appropriate out-of-home placement programs; and

• (i) continuous treatment that must be available twelve months of the year. The program must provide a minimum of 16 hours per month of CSCT services in summer months.

(2) CSCT services for youth with serious emotional disturbance (SED) must be provided according to an individualized treatment plan designed by a licensed or in-training mental health professional who is a staff member of a CSCT program team.

(3) The CSCT ITP team must include:

• (a) licensed or in-training mental health professional;

• (b) school administrator or designee;

• (c) parent(s) or legal representative/guardian;

• (d) the youth, as appropriate; and

• (e) other person(s) who are providing services, or who have knowledge or special expertise regarding the youth, as requested by the parent(s), legal representative/guardian, or the agencies.

(4) Providers must inform the youth and the parent(s)/legal representative/guardian that Medicaid requires coordination of CSCT with home support services and outpatient therapy.

(5) The CSCT program must employ sufficient qualified staff to deliver all CSCT services to youth as outlined in the ITP for the youth and in accordance with the contract between the school and mental health center.

(6) The CSCT program must employ or contract with a program supervisor who has daily overall responsibility for the CSCT program and who is knowledgeable about the mental health service and support needs of the youth. The program supervisor may provide direct CSCT services, but this position may not fill the functions of the staff positions described in (6) and (7) for more than three months.

(7) Each CSCT team must include a full-time equivalent mental health professional, who may be a licensed or in-training mental health professional, as defined in ARM 37.87.702(3). In-training mental health professionals must be:

• (a) supervised by a licensed mental health professional; and

• (b) licensed by the last day of the calendar year following the state fiscal year (July 1 through June 30) in which supervised hours were completed.

(8) Each CSCT team must include a full-time equivalent behavioral aide. A behavioral aide must work under the clinical oversight of a licensed mental health professional and provide services for which they have received training that do not duplicate the services of the licensed or in-training mental health professional. All behavioral aides initially employed after July 1, 2013 must have a high school diploma or a GED and at least two years:

• (a) experience working with emotionally disturbed youth;

• (b) providing direct services in a human services field; or

• (c) post-secondary education in human services.

(9) The licensed mental health center CSCT program supervisor and an appropriate school district representative must meet at least every 90 days during the time period CSCT services are provided to mutually assess program effectiveness utilizing, but not limited to, the following indicators:

• (a) progress on the individual treatment plan of each youth receiving CSCT services;

• (b) attendance;

• (c) CSCT program referrals;

• (d) contact with law enforcement;

• (e) referral to a higher level of care; and

• (f) discharges from the program.

(1) The licensed mental health center providing a comprehensive school and community treatment (CSCT) program must have a written contract with the school district.

(2) The mental health center must identify each school in which CSCT services will be provided, including:

• (a) specific services to be provided;
• (b) staffing by position and minimum qualifications; and
• (c) a description of the mental health services provided by the mental health center during and outside of normal classroom hours.

(3) The school must identify:

• (a) the provision of transportation and classroom space during non-school days as described in ARM 37.106.1956(1)(i);
• (b) the role of the school counselor and the school psychologist, as appropriate, in the provision of mental health services and supports to youth including coordination with the CSCT program;
• (c) program supports, including telephone, computer access, locking file cabinet(s), and copying, that the school will make available to CSCT staff while providing services within the school;
• (d) office space dedicated to CSCT which must be adequate and appropriate for confidentiality and privacy for the services provided; and
• (e) treatment space available to CSCT large enough to host a group during both school and nonschool days.