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UM Guidelines
Supported Housing: Residential Care

Behavioral Health (BH)

BCBST last reviewed September 20, 2017*

Clinical Indications for Admission to Residential Care

References

  1. Tsemberis, S., Eisenberg R. Pathways to housing: Supported Housing for street-dwelling homeless individuals with psychiatric disabilities; 2000. Retrieved May 22, 2014 from http://ps.psychiatryonline.org/data/Journals/PSS/3540/487.pdf.
  2. Owen C, Rutherford, V,Jones, M, Wright, C,Tennant C, Smallman, A. Housing accommodation preferences of people with psychiatric disabilities. Psychiatric Services 1996; 4(6), 628.
  3. McCarthy, J., Nelson, G. An evaluation of supportive housing for current and former psychiatric patients. Hospital and Community Psychiatry 1991; 42(12), 1254-56.
  4. Goering, P., Tolomiczenko, G., Sheldon, T., Boydell, K. , Wasylenki, D. Characteristics of persons who are homeless for the first time. 2002; retrieved May 22, 2014 from http://ps.psychiatryonline.org/data/Journals/PSS/3591/1472.pdf.
  5. Morrell-Bellai, T. Becoming and remaining homeless: a qualitative investigation. Mental Health Nursing 2000; 21(6), 581-604.
  6. Goldfinger, SM, Schutt, RK, Tolomiczenko, GS, Seidman, L, Penk, W, Turner,W, Caplan,B.   Housing placement and subsequent days homeless among formerly homeless adults with mental illness. Psychiatric Services 1999;50: 674- 678.
  7. Diamond, R.J. The psychiatrist’s role in Supported Housing. Hospital and Community 1993; Retrieved May 22, 2014 from http://ps.psychiatryonline.org/article.aspx?articleid=76782.
  8. Substance Abuse and Mental Health Services Administration. Permanent supportive housing: evaluating your program. HHS Pub. No. SMA-10-4509, Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services 2010.  http://store.samhsa.gov/shin/content/SMA10-4510/SMA10-4510-05-EvaluatingYourProgram-PSH.pdf.

Footnotes

[A] Supported Housing refers to residential settings staffed twenty four hours a day, seven days a week with associated mental health staff supports for seriously and persistent mentally ill (SPMI) individuals who are 18 years or older, who require services in a structured setting to maintain successful community tenure.  Supported Housing does not include room and board payment. Supported Housing utilizes a strengths model to assist individuals to remain in the community, functioning and progressing toward individualized recovery goals.  It also provides an environment that allows individuals to live in a structured community setting with appropriate mental health supports.  Comprehensive services focus on rehabilitation and include multidisciplinary, multimodal therapies to fit the needs of the resident. Medical and nursing services are generally available on a consultative basis. Typically, coordinated treatment services include individual, group, and family counseling, rehabilitation, vocational training, and skill building. Active family/significant other involvement is important unless contraindicated and should occur based on individual needs. Residents may go into the community for work, school, and/or outside activities. The expectation is that individuals will be integrated into the community at a level commensurate with the strengths and abilities of the individual as documented in the individuals’ treatment plan.  Community resources are used in a planned, purposeful, and therapeutic manner that encourages residents' autonomy. Supported Housing services are also effective in transitioning individuals with SPMI from child/adolescent services to adult continuum of services and assist them to remain in the community while accessing community based services. The expectation is that individuals will develop skills that foster independence and support the individual’s recovery plan.  Case Management Note: The receipt of Supported Housing and Case Management (Level 1 or 2) is considered a duplication of service and should not occur concurrently; however, Case Management is allowed and encouraged in order to assist with transition out of the Supported Housing Services no more than 90 days prior to discharge.

[B] Supervision in a structured setting for these members includes areas such as: health care and personal hygiene, finances, healthy diet and food preparation, home maintenance, and community services needs (e.g., legal, transportation, housing)

[C] Enhanced Supported Housing is equipped with additional safety precautions such as locks or alarms and more direct staff availability than regular Supported Housing.

[D] Medically Fragile Supported Housing is equipped with additional medical staff and accommodations such as wheelchair accessible showers and other accommodations over and above regular or Enhanced Supported Housing.

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