441—24.32 (225C) Crisis evaluation. Crisis evaluation consists of two components: crisis screening and crisis assessment.
	   24.32(1) Crisis screening. The purpose of crisis screening is to determine the presenting problem and appropriate level of care.
	      a.    	  Performance benchmark. Crisis screening includes a brief assessment of suicide lethality, substance use, alcohol use and safety needs. Crisis screening can be provided through contact with crisis response staff and through communication with the individual.
	      b.    	  Performance indicators.
	       (1)  	 Crisis response staff are trained in crisis screening.
	       (2)  	 A uniform process for crisis screening and referrals is outlined in policies and procedures.
	       (3)  	 Crisis screening records are kept in individual files.
	   24.32(2) Crisis assessment. The purpose of crisis assessment is to determine the precipitating factors of the crisis, the individual and family functioning needs, and the diagnosis if present and to initiate a stabilization plan and discharge plan. A licensed mental health professional conducts a crisis assessment within 24 hours of an individual’s admission to a crisis response service.
	      a.    	  Assessment requirements. The crisis assessment includes:
	       (1)  	 Action plan.
	       (2)  	 Active symptoms of psychosis.
	       (3)  	 Alcohol use.
	       (4)  	 Coping ability.
	       (5)  	 History of trauma.
	       (6)  	 Impulsivity or absence of protective factors.
	       (7)  	 Intensity and duration of depression.
	       (8)  	 Lethality assessment.
	       (9)  	 Level of external support available to the individual.
	       (10)  	 Medical history.
	       (11)  	 Physical health.
	       (12)  	 Prescription medication.
	       (13)  	 Crisis details.
	       (14)  	 Stress indicators and level of stress.
	       (15)  	 Substance use.
	      b.    	  Performance benchmark. Individuals receive comprehensive assessment by a mental health professional to determine the appropriate level of care.
	      c.    	  Performance indicators.
	       (1)  	 Written policies and procedures describe a uniform process for assessment, referrals and record documentation.
	       (2)  	 Mental health professionals as defined in Iowa Code section 228.1(6) will complete assessments.
	       (3)  	 Information collected is sufficient to determine the appropriate level of care.
	       (4)  	 Assessment results are explained to the individual and family or guardian when appropriate.
	       (5)  	 The individual’s strengths, preferences and needs are included in an action plan. The family or guardian may receive a copy of an action plan with a signed release.
[ARC 1660C, IAB 10/15/14, effective 12/1/14]