§334-103  Program elements.  Thefollowing shall be the program elements of the system.  These shall be designedto provide, at every level, alternatives to institutional settings.  Applicantsapplying to operate program elements shall show how each of these elementsworks with the current programs in the community the facility will serve. Applicants may apply for operation under the following program elements:

(1)  A short-term crisis residential alternative tohospitalization for individuals experiencing an acute episode or situationalcrisis.  The program shall be available for admissions twenty-four hours a day,seven days a week.  The primary focus of this element shall be on reduction ofthe crisis, stabilization, diagnostic evaluation, and assessment of theperson’s existing support system, including recommendations for referrals upondischarge.  This service in the program shall be designed for persons who wouldotherwise be referred to an acute inpatient psychiatric unit;

(2)  A long-term residential treatment program forclients who would otherwise be living marginally in the community with littleor no service support, and who would return many times to the hospital fortreatment.  It also will serve those who are referred to, and maintained in, statefacilities or nursing homes, or private or public facilities or programs undercontract with the director pursuant to section 334-2.5, because they requirelong-term, intensive support.  This service shall be designed to provide arehabilitation program for the so-called “chronic” patient who needs long-termsupport in order to develop independent living skills.  This program goesbeyond maintenance to provide an active rehabilitation focus for theseindividuals;

(3)  A transitional residential program designed forpersons who are able to take part in programs in the general community, butwho, without the support of counseling, as well as the therapeutic community,would be at risk of returning to the hospital.  These programs may employ avariety of staffing patterns and are for persons who are expected to movetoward a more independent living setting.  The clients shall be expected toplay a major role in the functioning of the household, and shall be encouragedto accept increasing levels of responsibility, both in the residentialcommunity, and in the community as a whole.  Residents are required to beinvolved in daytime activities outside of the facility which are relevant totheir personal goals and conducive to their achieving more self-sufficiency; or

(4)  A semisupervised, independent, but structuredliving arrangement for persons who do not need the intensive support of thesystem elements of paragraph (1), (2), or (3), but who, without some supportand structure, are at risk of requiring hospitalization.  The small cooperativehousing units shall function as independent households with direct linkages tostaff support in case of emergencies, as well as for regular assessment andevaluation meetings.  Individuals may use satellite housing as a transition toindependent living, or may remain in this setting indefinitely in order toavoid the need for more intensive settings.  This element is for persons whoonly need minimum professional or paraprofessional support in order to live inthe community.  These units should be as normative as the general livingarrangements in the communities in which they are developed. [L 1980, c 221, ptof §2; am L 1985, c 219, §1; am L 1986, c 237, §2; am L 1997, c 220, §3; am L1999, c 119, §7]