Licensed Psychologist in Dakota County, Minnesota

CLINIC-BASED SERVICES offers outpatient mental health services; provides psychotherapy and skills training for older adults and adults at each location.

Clinic-based services include:

• Individual Psychotherapy
• Family Counseling
• Marriage/Relationship Counseling
• Group Counseling
• Medication Management
• Training
• Workshops

Specialties include:

• Attention Deficit/Hyperactivity Treatment
• Chronic Pain and Illness
• Compulsive Gambling Issues
• Depression, Anxiety, and Phobias
• Dissociative Disorders
• Domestic Violence Issues
• Eating Disorders
• Elderly Mental Health Issues
• Employee Assistance Professional Services
• Grief Counseling
• Mood Disorders
• Obsessive Compulsive Disorder
• Personality Disorders
• Physical, Sexual, and Emotional Abuse
• Post-Traumatic Stress
• Schizophrenic Disorders
• Somatoform Disorders
• Sexual Orientation and Identity
• Sexuality Issues
• Work Stress/Problems

Our service of providing basic living and social skills are activities aim to give instruction, assistance, and support to a member. In doing so, we try to promote independence for everyday living. Considering that we are promoting patient-centered care, the service we provide is personalized to meet the specific needs of a client. Examples of skill areas we improve are:

• Interpersonal Communications
• Community Resource Utilization and Integration
• Crisis Assistance
• Relapse Prevention
• Budgeting, shopping, and healthy lifestyle skills and practices
• Cooking and nutrition
• Transportation
• Medication Monitoring
• Mental Illness Symptom Management
• Household Management
• Employment-Related Skills
• Transitioning to community living

Each member’s treatment plan is specially designed. It identifies the specific skills that are needed by a client, the ways to which these concerns are addressed, and the method (whether individually or by group) to be applied. Additionally, the medical necessity for each goal is also indicated. If it is appropriate to each participating member’s treatment needs and plan, we provide basic living and social skills individually or in a group setting. A basic living and social skills group is composed of 2 to 10 people. At least one of these individuals is an MA member. People may also bill Minnesota Health Care Programs (MHCP) for services provided to a group. Each staff person (up to two staff members) must bill for different members. We provide basic living and social skills directly (face-to-face) to the member. Do not bill if the contact is conducted by telephone.

A Certified Peer Specialist (CPS) provides rehabilitative services that are aimed towards acquiring, developing, and enhancing skills that a mental health patient needs to recover. The treatment plans they offer are personalized to meet the specific care needs of every individual under their care.

• CPS services include the following:

  • Non-clinical recovery-focused activities encouraging empowerment, self-determination, and decision-making (these services are exclusively provided by a CPS)
  • Activities that can address and contribute to the Adult Rehabilitative Mental Health Services (ARMHS) team; this includes providing insights about feelings associated with stigma, social isolation, personal loss, and systemic power dynamics. We also hope to restore one’s lifestyle following hospitalization and service their other acute care needs.

Community intervention is a service strategy that aims to do the following:

• Alleviate or reduce a member’s barriers to community integration or independent living.
• Minimize the risk of hospitalization or placement in a more restrictive living arrangement.

Community intervention is a service that may be provided with an agency, institution, employer, landlord, or member’s family. The involvement of these significant people is required in order to change situations and allow the member to function more independently.

Delivery of community intervention services meets the following:

• Must be directed exclusively to the treatment of the member.
• Must be provided on an individual basis only (cannot be provided in a group).
• May be conducted in person or by telephone if the intervention strategy warrants it (document accordingly).
• May be conducted without the member present when the intervention strategy warrants it (document why the strategy is more effective without the member present).

Community intervention will not be billed if the reasons below apply:

• Routine communication between members of a treatment team, routine staffing or a care conference.
• Telephone contacts that do not conform to the definition of this service or that are not properly documented.
• Clinical supervision or consultation with other professionals.
• Treatment plan development.

The billable service of a financial assessment (FA) includes the functional assessments, Level of Care Utilization System (LOCUS) assessments, and the interpretive summary. A comprehensive FA narrative describes how the person’s mental health symptoms impact their day-to-day functioning in a variety of roles and settings. As such, it is important to conduct an assessment of how factors other than mental health symptoms may impact life functioning. With the functional assessment conducted, our service aims to help an individual regain their life vision, goal, and purpose.

LOCUS

Assessment of functional ability informs the level of care utilization system (LOCUS) assessment. This, in turn, determines the service intensity needs of the individual. This assessment tool tries to identify the intensity of the resource needs of an individual, according to the mental health services they need.

Specifically, LOCUS tries to assess whether the following services are needed:

• Adult day treatment (Lvl. 3)
• Adult Rehabilitative Mental Health Services (ARMHS) (Lvl. 2-3)
• Assertive Community Treatment (ACT) (Lvl. 4)
• Intensive Community Rehabilitative Services (ICRS) (Lvl 3-4)
• Intensive Residential Treatment Services (IRTS) (Lvl. 5)
• Partial hospitalization (Lvl. 4)

Interpretive Summary

The interpretive summary conducted is done to synthesize the information gathered from the three-tier assessment process (diagnostic, functional, and LOCUS). This will help prioritize and determine the direction of the upcoming individual treatment plan. This process is an essential step in bridging the assessment to implementation or service planning.

An interpretive summary does the following:

• Identifies what outcomes the person desires relative to his or her life circumstances and preferences.
• Describes how mental health symptoms are affecting the person’s and his or her family’s life.
• Summarizes the nature of the functional barriers as they relate to symptoms of the mental illness to establish the priorities for the next treatment plan.
• Examines the person’s strengths, abilities, and resources.
• Examines how the person’s strengths, abilities, and resources can be engaged to improve functioning and move forward on identified desirable recovery outcomes.
• Establishes the priorities for the initial and subsequent individual treatment plan.
• Recommends services and interventions.

The mental health clinical supervisor/practitioners, under the supervision of the clinical supervisor, is to one to complete the interpretive summary. To assure the protection of the patient, those involved in the process will be signing the document report.

An individual treatment plan (ITP) is a written document that outlines the treatment strategy of a patient. It also includes the schedule for accomplishing the goals and objectives of the treatment plan. Lastly, it contains the responsibility of each party in the treatment. The ITP is required in order to proceed with the mental health service delivery.

An ITP of any ARMHS is based on a diagnostic and functional assessment, documents the plan of care and guides treatment interventions. Development of the ITP includes involvement of the client, client’s family, caregivers or other people, which may include people authorized to consent to mental health services for the client, and includes an arrangement of treatment and support activities consistent with the client’s cultural and linguistic needs.

The ITP tries to look into the goals and priorities of the intervention. This will help assess and assure that the treatment goals are met throughout the process of intervention. The plan must be written in a way in which the person and his or her family have a clear understanding of the services being offered and specifically how the services will address their concerns. The person must take part in the process of developing the ITP to make sure the treatment is relevant to the priorities and incorporates his or her strengths.

The ITP for adults contains the following components:

• Cultural considerations, as related to the service plan and delivery
• A list of functional barriers to be addressed in the plan
• Strength and resources that are a benefit in this time of change
• Referrals to be pursued, if any

• Information about service coordination that identifies the following:

  • Other service providers
  • The service
  • Frequency and form of routine contact between ARMHS and other providers
• Documentation of progress (or lack thereof) as a written review that evaluates progress toward goals and objectives from the previous plan
• Signature and dateline for the member or legal guardian and ARMHS provider
• It is important to provide a guardian with a signed copy of the document. If a person refuses to sign the plan, document efforts to engage the person in his or her treatment plan and why he or she was not willing to sign the plan.

• Additional requirements for the ITP include the following:

  • Recovery vision: Reflects the person’s aspirations regarding his or her life stated in his or her own words.
  • Goal (Rehab): A target for change that is achievable within nine months to three years. A goal describes a target for change that will result in achieving the desired outcome. The recommendations section outlines no more than two rehabilitative goals.
  • Objectives: Achievable within six months or less. A small positive forward step describing what the person will be able to do or the result to be realized. The ITP outlines the small steps the person will take. The recommendation is no more than three objectives that can be targeted sequentially or concurrently to attain the goal. Objectives are measurable and observable with an identified baseline and target measure.

  • Interventions: Rehabilitation techniques that ARMHS staff will use to help a person reach objectives, which lead to completing goals. Intervention can focus on utilizing community resources such as natural support networks, skill development, mastery, or generalization. The intervention must include the following:

    • A proposed timeline for completion
    • Identified skills or skill set to be learned, mastered or generalized
    • Where the intervention will take place
    • Description of the type of rehabilitative intervention to be used such as demonstrating, modeling, showing or practicing
    • Type of service method, one-on-one or group
    • Length of a typical session
    • Frequency of session
    • Timeframes for rehabilitative objectives and interventions
    • Service Category: Basic living and social skills (BLSS), medication education (ME), community intervention (CI), a transition to community living (TCL) or certified peer specialist (CPS)

Timeframe

A mental health professional/practitioner, under the clinical supervision of a mental health professional, must comply with the following:

• Develop and approve an ITP within 30 days of the ARMHS intake or start date
• Update the ITP every six months, at a minimum

Signatures

The ITP requires the signature of the following individuals:

• The member must sign and receive a copy of the ITP; if the member is unable to sign the ITP, a reason must be listed
• The mental health professional and mental health practitioner under the clinical supervision of a mental health professional

The purpose of medication education service is to educate a member regarding the following:

• Mental illness and symptoms
• The role and effects of medications in treating symptoms of mental illness
• The side effects of medications

Medical education is a service coordinated with medication management. Although similar, these two services serve separate purposes. In billing this service, the member must be present.

Detailed below are the criteria for medication education:

• May include activities that instruct members, families or significant others in the correct procedures for maintaining the member’s prescription medication regimen
• May be provided individually or in a group setting
• Must be provided only by a physician, pharmacist, registered nurse or physician’s assistant employed by or subcontracted with a certified ARMHS provider. The ARMHS provider bills for medication education

If medication education is provided within a pharmacy setting, it is important to ensure that the service is provided apart from the dispensing area. Medical education was never intended to take the place of any aspect of dispensing medications. As such, the information provided to a member as part of a prescription is an aspect of dispensing medications. This must be paid separately from medical education.

The purpose of the transition to community living (TCL) services are the following:

• To establish or re-establish contact between an ARMHS provider and the member before the member’s discharge from a higher level of care mental health service, including any of the following:

  • Regional Treatment Center
  • Community hospital
  • IMD
  • Intensive residential treatment program
  • Board and care facility
  • Skilled nursing home
  • ACT program
• To implement the discharge plan developed by the higher level of care mental health service
• To be coordinated with, but not duplicate, the discharge planning responsibilities of the higher level of care service
• To be provided within a maximum of 180 days of discharge from the higher level of care service
• TCL services cannot be provided concurrently with other ARMHS services. There are some limitations to the TCL services as it is only available to members receiving high levels of care service. In order to avail of TCL services, an individual must be authorized as per the regulation set out by the Authorization Requirements for TCL Services.

Adult Rehabilitative Mental Health Services (ARMHS) is a skill-building service for adults (over 18-years old) with mental health diagnoses as well as functional limitations due to the illness. Mental health practitioners teach, coach, support, and do “along with” the client as they navigate the path of their illness.

Areas of focus may include:

• Interpersonal communication skills
• Community resource utilization and integration skills
• Crisis assistance
• Relapse prevention skills
• Health care directives
• Budgeting and shopping skills
• Healthy lifestyle skills and practices
• Cooking and nutrition skills
• Transportation skills
• Medication monitoring
• Mental illness symptom management skills
• Household management skills
• Employment-related skills
• Parenting skills

Individuals need to have a diagnostic assessment completed by a Mental Health Therapist that indicates it is medically necessary for them to receive the service and explain the functional impairment.

The service is provided at the client’s home or in the client’s community.