Intensive Residential Treatment Service (IRTS)

  
Cooper Commons are licensed by the State of Missouri as an Intensive Residential Treatment Service (IRTS). This program is comprised of an array of medically necessary on-site residential services for adults whose severity and chronicity of mental illness is such that they either failed in multiple community settings and/or present an ongoing risk of harm to self or others, which would likely result in long-term psychiatric hospitalization. The program provides intensive mental health treatment services to male adults who are 18 years or older and meet the admission criteria for Community Psychiatric Rehabilitation (CPR). Individuals are accepted without regard to race, creed, national origin, gender, disability or sexual orientation.   
 
  • The Cooper Commons Intensive Residential Treatment Services (IRTS) Program is located at 501 Highway 61 J North in Hayti, Missouri. The program accommodates up to six (6) long-term residents in private rooms for a duration of stay in this setting that could range from ninety (90) days or less to many years, if this service level remains the least restrictive environment. The Program also acconodates for up to four (4) residents for a maximum of 30-days, although extensions of treatment are possible with a prior authorization based on medical necessity.  Business office hours are Monday through Friday 8:00am - 5:00pm.
 
​Both IRTS Programs require on-site staff, 24-hours a day, seven (7) days a week, to ensure that person(s)-served do not engage in behaviors that are harmful to themselves or others, or in activities that involve a high risk of relapse of psychiatric symptoms or other behaviors requiring long-term hospitalization. Professional staff includes a Qualified Mental Health Professional, Mental Health Rehab Worker, Care Coordinator and a Registered Nurse. The residential home provides a relaxing, comfortable home like environment.  
 
An array of services and supports delivered by residential staff may with consideration of person(s)-served needs, be included in the daily care:
 
  • Intensive clinical interventions and supports to reduce symptoms of mental illness
  • Intervention and redirection of person(s)-served who are in psychiatric crisis and are   exhibiting behaviors that are potentially dangerous to themselves or others;
  • Back-up and emergency services and crisis supports;
  • Monitoring of psychiatric symptoms;
  • Assistance with medications;
  • Supervision, assistance, and/or monitoring of medical treatment;
  • Assistance, prompts, education, and support for conflict and resolution, behavior redirection, coping skills, etc;
  • Assistance and education associated with activities of daily living development: healthy living, cooking and nutrition, transportation as needed, household management, budgeting, etc;
  • Engagement in, and coordination of, services for social and recreational, pre-vocational and vocational activities;
  • Supports needed to provide protective oversight;
  • Monitor points of ingress/egress; and
  • Periodic room checks
 
Rehabilitation services are available both on-site and in the community to promote symptom amelioration and psychiatric recovery, and to assist the person(s)-served in progressing toward less intensive services. The program provides treatment at least four hours a day, seven days a week and consists of three (3) or more of the following:
 
  • Therapeutic activities such as individual and group counseling;
  • Educational activities
  • Training activities
  • Crisis intervention
  • Development of community living skills
  • Family support with approval of the person(s)-served
  • Linkages to community resources
  • Advocacy
  • Education on wellness and recovery
  • Development of a social support network
  • Development of vocational skills
  • Education/training in selection and maintenance of housing that is safe, decent, affordable and accessible
  • Development of recreational and leisure skills
  • Medical care and/or therapies
 
Upon entering treatment, a person(s)-served may initially have limitations in activities while adjusting to the residence; this may  include utilizing escorts as necessary and periodic room checks for the first thirty (30) days.
 
Funding Sources for the IRTS Program include private healthcare insurance, Purchase of Service (POS) Funds through DBH, Medicaid, and self-pay. The ability to pay is based on the DBH sliding scale and the income of the person(s)-served. The fees are determined by family income and number of dependents. If it is determined a person(s)-served has a monthly fee from the sliding scale, the fee is collected upon admission and at the first of each month for the remainder of the time the person(s)-served remains active in treatment services. 
 
Person(s)-served are referred from a variety of sources to include, but not limited to, self and family referrals; court system; Division of Family Services (DFS); Department of Corrections (DOC); hospitals; physicians; community agencies; private practitioners; and other community mental health centers.
Summary of Services
 
The Intensive Residential Treatment Service (IRTS) Program is designed to provide assistance to individuals that are residing in a residential setting that serves the adult population of mentally ill individuals who require increased structure, oversight and support in order to remain in the community. This service level may be used to assist individuals in their transition from state facilities to the community and to provide a temporary alternative setting for consumers currently in the community who are in danger of returning to inpatient care due to their clinical status or need for increased supervision. This level of service may benefit individuals that are forensic and those with intractable psychiatric symptoms; history of problematic behaviors (e.g. antisocial, elopement, substance abuse); and institutional dependency. The Program is compliant with applicable state and federal Medicaid requirements. Service delivery models and strategies are based on accepted practice in the field and the practice of evidence based treatment modalities. The services provided within the program are planned and coordinated with the local mental health service delivery system. Person(s)-served may access and receive services outside our facility for which they are eligible, specifically in situations when it would further the continuity of treatment and transition to the community. The IRTS Program offers the following services:
 
Residential Treatment Service. Intensive Residential Treatment Service (IRTS) offers 24-hour supervision in a residential setting, seven (7) days a week. At least four (4) hours of structured therapeutic activities are provided daily, seven (7) days per week. The residential setting shall ensure the safety and well-being of person(s)-served
 
Assessment, Evaluation and Consultation Services. Person(s)-served can meet with a clinician for a thorough assessment of strengths, needs, abilities, and preferences. Upon completion of the assessment, the clinical therapist determines level/intensity of care and presents recommendations to the clinical team for review.
 
Crisis Assessment and Intervention. All person(s)-served have access to emergency services, either over the phone or face-to-face, seven (7) days a week, twenty-four (24) hours per day. MOCARS, our access/ crisis hotline provides this service after hours. On some occasions, it is necessary to access involuntary admissions for person(s)-served if they pose a threat to themselves or others; however, this is utilized as a last resort. A Qualified Mental Health Professional (QMHP) makes the final determination regarding this option and follows the protocol as written. 
 
Community Support services, which consists of specific activities in collaboration with, or on behalf of the person(s)-served, are delivered in accordance with the person-served care plan. Community Support services maximize adjustment and functioning within the community while achieving sobriety and sustaining recovery, maximizing the involvement of natural support systems, and promoting independence and responsibility. Care Coordinators assist the individual in identifying available community resources and services to help them achieve recovery care plan goals. Care Coordinators have a working knowledge of health care, social services, employment, safe housing, recreational opportunities, transportation, and other services and systems available in the community. Care Coordinators also provide educational services regarding various daily living skills such as budgeting, meal planning and personal care. Community Support services are provided in any setting that allows the best access to services. Settings may include the treatment center, medical clinics, schools and/or community businesses. 
 
Peer Support services are person-centered with a recovery focus. Services allow individuals the opportunity to direct their own recovery and advocacy processes. Peer support promotes skills for coping with and managing symptoms while encouraging the use of natural supports and enhancement of community living skills. Services are provided by a Certified Missouri Peer Specialist.
 
Psychosocial Rehabilitation (PSR) Program is for individuals with a history of serious mental illness that can benefit for additional support services. The activities of the PSR Program focus on the development of behaviors and abilities that will allow the person(s)-served to return to activities that are age appropriate and based on assessed need;  development of behaviors and abilities that allow the person(s)-served to participate in community living; prevention of extended hospitalizations; establish and improve an individual’s desire or motivation to maximize independence; development of a personal support system and provision of meaningful activity which is appropriate to the age and interest of the person(s)-served.
 
  • The PSR program may provide illness management and recovery services that promote physical and mental wellness, well-being, self-direction, personal empowerment, respect and responsibility in individual and group settings.
 
  • Group professional PSR may be provided utilizing skills based approach to address identified behavioral problems and functional deficits relating to a mental disorder that interferes with an individual’s personal, family or community adjustment. 
 
Group Education consists of the presentation of general information and application of the information to participants through group discussion in accordance with individualized treatment plans which are designed to promote recovery and enhance social functioning. The usual and customary size of group educational sessions shall not exceed thirty (30) person(s)-served. 
 
Psychosocial Rehabilitation Illness Management and Recovery services are provided individually or in a small group setting with a focus on recovery and the management of mental illness. Key service functions include: 
 
  • Psychoeducation;
  • Relapse prevention; and
  • Coping skills training
 
Individual Counseling is a structured, goal-oriented therapeutic process in which the person(s)-served interacts on a face-to-face basis with a counselor in accordance with the individual’s rehabilitation plan in order to resolve problems.
 
Group Professional Psychosocial Rehabilitation. Group mental health interventions using a skills based approach to address identified behavioral problems and functional deficits relating to a mental disorder that interferes with an individual’s personal, family, or community adjustment. Maximum group size is one (1) professional to eight (8) consumers. Services must be documented according to the requirements set forth in 9 CSR 30-4.035 8 (B).                                                              
 
Integrated Dual Disorders Treatment (IDDT) services are provided to those identified as having both a substance use diagnosis and a mental health diagnosis. Co-occurring issues are integrated into the person centered care plan and are provided by qualified personnel.
 
Co-Occurring Individual Counseling is provided resolve problems related to the mental disorders and substance use disorders that interfere with functioning.
 
Co-Occurring Group Counseling is designed to promote individual self-understanding, self-esteem, and resolution of personal problems through personal disclosure and interpersonal interaction among group members. Group size shall not exceed ten (10) individuals.
 
Co-Occurring Group Education services are provided with the primary goal of restoring lost functioning and promote reintegration and recovery through knowledge of one’s disease, symptoms, understanding of the precursors to crisis, crisis planning, community resources, recovery management, and medication action and interaction. Group size shall not exceed twenty (20) individuals.
 
Medication Management.
 
  • Psychiatry services are routinely scheduled at 2-3 month intervals with urgent appointments available every day, if needed. All psychiatrists are board certified and supervise all work of the psychiatric nurse practitioners (PMHNP). Psychiatrists/PMHNP’s assume the responsibility for the medication aspects of mental health care, including: Psychiatric evaluations, medication management, review of complex cases where physical and mental health issues intersect, organicity, seizure disorders, psychosomatic disorders, and other medical and psychiatric related disorders.
 
  • Telemedicine Psychiatry services are also available through web browser Telehealth appointments at our satellite location to assist in continuity of care.
 
  • Medication Assisted Treatment (MAT) is an evidenced based practice that combines pharmacological interventions with substance abuse counseling and social support. Although not for everyone, it is an essential part of the comprehensive array of services available to people struggling with addiction to alcohol or other drugs. The LPN/RN at the Clinic delivers the injection as ordered by the psychiatrist.
 
  • Medication administration may include arranging appointments with an RN or LPN for injections of psychotropic medications as ordered by the psychiatrist as well as assistance with Patient Assistance programs for free or discounted medications as ordered by the psychiatrist.
 
  • Medication administration support may include coordination of medication needs with families, person(s)-served, and/or pharmacies (including the use of indigent drug programs); setting up medication boxes; monitoring medication compliance, person’s vitals, and laboratories ordered by the psychiatrist; and perform metabolic screenings.
 
Family Counseling Center, Inc. is not a doctor-only facility; therefore, it is our policy the person(s)-served is receiving additional treatment services.
 
Healthcare Information and Community Resource, Support and Referrals. A Nurse Care Manager (NCM) is available to provide health home services to individuals with certain chronic illnesses. The NCM coordinates care among both primary and specialty medical care services. The NCM also promotes healthy lifestyles and supports person(s)-served in managing their chronic health conditions via education, referrals, and information and handouts.
 
Metabolic Syndrome Screening can be provided annually for person(s)-served who are receiving antipsychotic medications. Screening is performed for the following risk factors: obesity, hypertension, hyperlipidemia, and diabetes.
  
Program Locations Include:
 
 
Program Handbook