SECTION K: ACUTE PARTIAL HOSPITALIZATION SERVICES (Revised 6/22/10)
Acute Partial Hospitalization is a program that provides medical supervision, nursing services,
structured therapeutic activities and intensive psychotherapy (individual, family and/or group) to
individuals who are experiencing a period of such acute distress that their ability to cope with
normal life circumstances is severely impaired. Acute Partial Hospitalization is designed to
provide an alternative to inpatient hospitalization for such individuals or to serve as a bridge
from inpatient to outpatient treatment. Program content may vary based on need but must
include close observation/supervision and intensive support with a focus on the
reduction/elimination of acute symptoms. Acute Partial Hospitalization may be provided to
children with serious emotional disturbance and/or mental retardation/developmental disabilities
or adults with serious and persistent mental illness or mental retardation/developmental
4600.0 The acute partial hospitalization program must be a part of a written
comprehensive plan of crisis stabilization and community support services that
includes, at a minimum, family interventions, intensive case management,
medication monitoring, and other community support activities. The partial
hospitalization program must be designed to assist individuals in making the
transition from acute inpatient services, and/or serve as an alternative to inpatient
The Capps Crisis Stabilization Unit (CCSU) will house the Delta Community
Mental Health Services Acute Partial Hospitalization (APH) program. This APH
program will be designed and implemented with CCSU residents. The APH
program is specifically designed to decrease the need for more restrictive
inpatient care such as Mississippi State Hospital (MSH) and to assist the
individuals in making the transition to a less restrictive setting (e.g., outpatient
services, community placement, group home, etc). Family intervention, intensive
case management, medication monitoring, and other community support activities
are also components of the APH program.
4600.1 There must be written policies and procedures implemented for providing acute
partial hospitalization services that include at a minimum:
a. Admission criteria and procedures. These procedures must require that a
physician conduct an admission evaluation and certify that the service is
required to reduce or prevent inpatient services.
All APH program participants must be at least 18 years of age and have a
primary SMI diagnosis. Dually diagnosed individuals will be considered only if
the primary diagnosis is an SPMI diagnosis. Referrals can be made by DCMHS
staff, family members, law enforcement agencies, local hospitals, county courts,
MSH, or other community resources. The APH Master’s level clinician or other
clinical staff will conduct a full triage and psychosocial Intake/Assessment to
determine the appropriateness for placement at CCSU. If an individual is
admitted to CCSU and deemed appropriate for participation in the APH program,
an appropriate comprehensive treatment plan (CPT) will be constructed. The
individual will then be evaluated by the program physician for official
certification that APH is a necessary service to prevent or reduce inpatient
services. This certification is noted on the individual’s CPT and filed in their
Residents of the CCSU will be enrolled in APH only after such enrollment is
determined by the CCSU Program Director and Program Therapist to be
appropriate in light of the resident’s readiness for such enrollment.
b. Procedures requiring documented medical supervision and follow along
with on-going evaluation of the medical status of the individual.
Each individual in the APH program will have been assessed communicable
diseases upon admission to CCSU program by the CCSU program physician
and/or nurse practitioner. Further, each individual is monitored daily by a nurse
and at least twice weekly by the program physician/nurse practitioner. At
discharge, a follow-up appointment is made with both a physician and/or nurse
practitioner within two weeks. Notification of these contacts is kept in the
individual’s CCSU chart.
c. Procedures requiring documented support services for families and
The CCSU and APH programs recognize the treatment benefits of family
involvement and make this benefit known to all participants. With participant
approval of family therapy and collateral contacts on the CPT, family members
are strongly encouraged to participate in the individual’s treatment via family
therapy and education sessions, case management contacts, discharge planning,
etc. If a family member is unable to attend sessions, family members are kept
abreast via telephone contacts with the CCSU Program Director or other
designated CCSU and APH staff. Contacts with family are only initiated with the
written consent of the individual. Documentation of contacts is kept in the
individual’s CCSH chart.
d. Procedures implementing and documenting discharge criteria to include
A pre-discharge plan is formulated for each individual at time of admission to
CCSU and the APT. Goals and objectives for discharge are detailed in the
individuals CTP. Treatment objectives are specifically outlined and the
individual agrees to and signs this treatment plan. At time of discharge, follow-
up recommendations are made which include at a minimum a follow-up
appointment with a physician and psychiatric nurse. Other follow-up services
may include psychosocial rehabilitation, case management (MIMS, intensive, or
regular), individual therapy, residential placement, etc.
4600.2 The staff for the acute partial hospitalization program must include at each site a
full time director who plans, coordinates, and evaluates the service and who has,
at a minimum, a Master’s degree in a mental health or related field.
The APH program staff will be coordinated by a Master’s level clinician who is
also a DMH certified mental health therapist. This therapist will be responsible
for maintaining documentation of the individual’s progress towards APH
objectives and ensuring communication between APH and CCSU staff.
4600.3 The provider must ensure that the staff on-site are of a sufficient number to
provide adequate assistance and supervision in a safe, therapeutic environment
and must meet the following minimum requirements:
a. At least one (1) staff member with a minimum of a Master’s degree in a
mental health or related field must be on-site for six (6) or fewer persons for
which the program is certified to serve. (Staff can be the Program Director.)
b. At least one (1) staff member with a minimum of a Master’s degree in a
mental health or related field and at least one (1) staff with a minimum of a
Bachelor’s degree in a mental health or related field when seven (7) through
twelve (12) participants are served.
c. At least one (1) staff with a minimum of a Master’s degree in a mental
health or related field, at least one (1) staff with a minimum of a Bachelor’s
degree in a mental health or related field and least one (1) support staff when
thirteen (13) through eighteen (18) participants are served in the program.
The CCSU will have at a minimum one staff member with a Master’s degree in a
mental health or related field with DMH certification, at least one member with a
minimum of a Bachelor’s degree in a mental health related field and at least one
support person staff. The maximum members served will be sixteen.
4600.4 The acute partial hospitalization program must provide adequate nursing and
psychiatric services to all individuals served. At a minimum, these services must
be provided weekly (and more often if clinically indicated). These services must
be documented through an implemented written procedure carried out by the
certified DMH provider or through contractual agreement.
The APH program will provide psychiatric nursing services and physician
services at least twice weekly. More frequent services of this type will be provided
when clinically indicated. The CCSU staff physician and psychiatrist are
accessible at other times if needed when emergency circumstances arise.
4600.5 The acute partial hospitalization program must:
a. Operate a minimum of three days per week
The APH program at CCSU will operate five days per week.
b. Operate a minimum of four hours per day, excluding transportation time;
The APA program at CCSU will operate five hours per day.
c. Be available twelve (12) months per year.
The APH program is available twelve months per year.
4600.6 The acute partial hospitalization program must be designed for a maximum
number of eighteen (18) individuals with a maximum length of stay of thirty (30)
service days. Service in the acute partial hospitalization program may only go
beyond thirty (30) service days with written justification provided by the
attending psychiatrist. Stays longer than sixty (60) service days in any year must
be justified to the Department of Mental Health and written approval from the
Department must be included in the record.
The CCSU APH program is designed to serve no more than 16 individuals. The
maximum length of stay will not exceed 30 days without written justification from
the attending psychiatrist. Any stay longer than 60 days will be justified to DMH
and written approval from the DMH will be included in the record.
4600.7 The provider must maintain a daily schedule of therapeutic activities to include
individual, group, family, and other activities.
The APH has a daily schedule of therapeutic activities which will include at a
minimum individual, group, family, and social activities. (ATTACHMENT A)
4600.8 The facility must have sufficient space to accommodate the full range of program
activities and services and must provide a minimum of eighty (80) square feet of
multipurpose space for each individual served.
The CCSU facility and APH program area provides at a minimum of 80 square
feet of multipurpose space for each individual served.
4600.9 The program must have a certificate from the Department of Mental Health that
establishes the total capacity of each acute partial hospitalization site. The number
of individuals that the service has been certified to serve cannot be exceeded.
A DMH certification which establishes these guidelines is displayed in a
Appendix A: DMH Standard 4600.7
CAPPS CRISIS STABILIZATION CENTER
DELTA COMMUNITY MENTAL HEALTH SERVICES
DAILY: MONDAY THROUGH FRIDAY
(Note: Acute Partial Hospital Services occur 9AM to 3PM, excluding lunch)
6AM - 8AM Personal ADLs (shower, dress, straighten room and bed) vital signs, breakfast, smoke
break, morning medications; Psychiatry rounds on Tue, Thurs [Support staff, Nurses,
8AM - 8:30AM New admission introductions; Psychiatry rounds [Support staff, Nurses, Psychiatrist]
8:30AM – 9AM RECREATIONAL ACTIVITY GROUP [Support staff], Treatment Team meeting on
Monday and Thursday [Program Dir., Therapists, Nurse(s), Case Manager(s), Specific
resident(s), Support staff]
9AM – 9:30AM MORNING ‘CIRCLE ORIENTATION AND GOAL SETTING GROUP [Nurse(s),
APH BEGINS Support staff]; Psychiatry rounds; Case management linkage [Case Manager(s)]
9:30 – 10AM Snack and smoke break for residents[Support staff]; Treatment Team meeting continues
[Program Dir., Therapist(s), Nurse(s), Case Manager(s), Specific resident(s), Support
10AM – 10:30AM MEDICATION EDUCATION AND MEDICATION ASPECTS GROUP [Nurse(s),
Therapist(s), Program Director]; Individual & Family Therapy continues [Therapist(s),
10:30AM – NOON Individual & Family therapy continues [Therapist(s)]; STRESS AND CRISIS COPING
GROUP for those residents not in individual or family sessions [Program Director,
NOON – 1PM Lunch; Smoke break [Support staff]; Mid-day medications [Nurse(s), Support staff]
1PM – 1:30PM Free time, TV time
1:30PM – 2:30PM RELAPSE PREVENTION GROUP (Dual Dx. & SMI) [Program Director &
2:30PM – 3PM ‘WRAP-UP’ GROUP [Program Director, Therapist(s), Nurses, Support staff,
APH ENDS Psychiatrist when available]
3PM – 3:30PM Free time, TV time, PRN Psychiatry rounds (face-to-face or telemedicine)
3:30PM – 4:30PM Individual therapy sessions, Case Management linkage and follow-up, PRN Psychiatry
rounds (face-to-face or telemedicine), Individual medication education
4:30PM – 5PM RECREATIONAL ACTIVITY GROUP [Support staff]; Case Management linkage and
follow-up, PRN Psychiatry rounds (face-to-face or telemedicine), Individual medication
5PM – 6PM Dinner and smoke break
6PM – 7PM Outside privileges; Telephone privileges, and PROCESS GROUP to discuss daily events
and accomplishments [Nurse(s) & Support staff]
7PM – 9PM Evening medications [Nurse(s) & Support staff]; Free time, telephone privileges,
9PM – 11PM Quiet time/Lights out at 10PM
NOTE: Weekend scheduling will include all the above medication education programming as well as specialized
groups and family visitation opportunities. Psychiatry rounds or admission consultations will be arranged on a PRN
basis through face-to-face contact or telemedicine. In voluntary admission cases, transportation to local AA or NA
meetings may also be provided on a case-by-case basis.