Services
What We Offer
Our Services
Soaring Eagles Va offers person-centered programs that combines skill-based interventions with maximum flexibility so that services are available to individuals and families according to their unique physical and emotional needs.
Intensive In-Home services (IIH)
Intensive in-home services (IIH) for youth under age 21 are intensive therapeutic interventions provided in the youth’s residence (or other community settings as medically necessary and documented in the Comprehensive Needs Assessment and ISP), to improve family functioning, and significant functional impairments in major life activities that have occurred due to the youth’s mental, behavioral or emotional illness in order to prevent an out of home placement, stabilize the youth, and gradually transition the youth to less restrictive levels of care and supports. All IIH services shall be designed to specifically improve family dynamics, provide modeling, and include clinically necessary interventions that increase functional and therapeutic interpersonal relations between family members in the home. IIH services are designed to promote benefits of psychoeducation in the home setting of a youth who is at risk of being moved into an out-of-home placement or who is being transitioned to home from an out-of-home placement due to a documented medical need of the youth. At least one parent/legal guardian or responsible adult with whom the youth is living must be willing to participate in the intensive in-home services with the goal of keeping the youth with the family.
Medical Necessity Criteria for IIH
Youth receiving IIH Services must have the functional capability to understand and benefit from the required activities and counseling of this service. These services are rehabilitative and are intended to improve the youth’s functioning. It is unlikely that youth with severe cognitive and developmental delays/impairments would clinically benefit and meet the service eligibility criteria. Prior to the start of services, a valid Comprehensive Needs Assessment, as defined earlier in this chapter, shall be conducted by the LMHP, LMHP-S, LMHP-R, or LMHP-RP, documenting the youth’s diagnosis and describing how service needs can best be met through intervention provided typically but not solely in the youth’s residence. The Comprehensive Needs Assessment describes how the youth’s clinical needs put the youth at risk of out-of- home placement. Youth shall meet all of the following criteria including Diagnostic, At Risk, Level of Care and Family Involvement to qualify for IIH services.
1. Diagnostic CriteriaYouth qualifying for this service shall demonstrate a clinical necessity for the service arising from mental, behavioral or emotional illness which results in significant functional impairments in major life activities. The diagnosis must be the primary clinical issue addressed by services and must support the mental, behavioral or emotional illness attributed to the recent significant functional impairments in major life activities.
2. At Risk Criteria
The impairments experienced by the member are to such a degree that they shall meet at least two of the criteria below, on a continuing or intermittent basis, for being at risk of out of home placement as defined in definitions section.
a. Have difficulty in establishing or maintaining normal interpersonal relationships to such a degree that they are at risk of hospitalization or out-of-home placement as defined in the definition section of this manual because of conflicts with family or community; and/or
b. Exhibit such inappropriate behavior that documented, repeated interventions by the mental health, social services, or judicial system are or have been necessary resulting in being at risk for out of home placement; and/or
c. Exhibit difficulty in cognitive ability such that they’re unable to recognize personal danger or recognize significantly inappropriate social behavior resulting in being at risk for out of home placement.
3. Level of Care:
The impairments experienced by the member are to such a degree that they shall meet one of the criteria below:
a. When services that are far more intensive than outpatient clinic care are required to stabilize the youth in the family situation, or
b. When the youth’s residence as the setting for services is more likely to be successful than a clinic.
4. Family Involvement:
At least one parent/legal guardian or responsible adult with whom the youth is living shall be willing to participate in the intensive in-home services with the goal of keeping the youth with the family. In the instance of this service, a responsible adult shall be an adult who lives in the same household with the child and is responsible for engaging in counseling and service-related activities to benefit the youth.
Crisis Community Stabilization
Community Stabilization services are short-term and designed to support an individual and their natural support system following contact with an initial crisis response service or as a diversion to a higher level of care. Providers deliver community stabilization services in an individual’s natural environment and provide referral and linkage to other community- based services at the appropriate level of care. Interventions may include brief therapeutic and skill building interventions, engagement of natural supports, interventions to integrate natural supports in the de-escalation and stabilization of the crisis, and coordination of follow-up services. Coordination of specialized services to address the needs of co-occurring intellectual/developmental disabilities and substance use are also available through this service. Services should involve advocacy and networking to provide linkages and referrals to appropriate community-based services and assisting the individual and their family or caregiver in accessing other benefits or assistance programs for which they may be eligible.
Medical Necessity Criteria
The Comprehensive Needs Assessment must document the need for crisis stabilization services. To qualify for this service, individuals must demonstrate a clinical necessity for the service arising from a condition due to an acute crisis of a psychiatric nature that puts the individual at risk of psychiatric hospitalization. Individuals must meet at least two of the following criteria at the time of admission to the service:
1. Experiencing difficulty in establishing and maintaining normal interpersonal relationships to such a degree that they are at risk of psychiatric hospitalization or homelessness or isolation from social supports.
2. Experiencing difficulty in activities of daily living (ADLs) such as maintaining personal hygiene, preparing food and maintaining adequate nutrition, or managing finances to such a degree that health or safety is jeopardized.
3. Exhibiting such inappropriate behavior that immediate interventions by mental health, social services, or the judicial system are or have been necessary.
4. Exhibiting difficulty in cognitive ability (such that the individual is unable to recognize personal danger or recognize significantly inappropriate social behavior).
Individuals may not receive Crisis Stabilization when they meet the exclusion criteria below:
Exclusion Criteria:
This service is not reimbursable for any of the following reasons:
1) Individuals with medical conditions which require hospital care;
2) Individuals with a primary diagnosis of substance use disorder;
3) Individuals with psychiatric conditions which cannot be managed in the community, such as individuals who are of imminent danger to self or others.
Mental Health Skill Building Services
Mental health skill-building services (MHSS) shall be defined as goal directed training and supports to enable restoration of an individual to the highest level of baseline functioning and achieve and maintain community stability and independence in the most appropriate, least restrictive environment. MHSS services shall provide face to face activities, instruction, interventions, and goal directed trainings that are designed to restore functioning and that are defined in the ISP in order to be reimbursed by Medicaid. MHSS shall include goal directed training in the following areas: (i) functional skills and appropriate behavior related to the individual’s health and safety; instrumental activities of daily living, and use of community resources; (ii) assistance with medication management; and (iii) monitoring health, nutrition, and physical condition with goals towards self-monitoring and self-regulation of all of these activities.
Medical Necessity Criteria
Individuals qualifying for MHSS must demonstrate a clinical necessity for the service arising from a condition due to mental, behavioral, or emotional illness that results in significant functional impairments in major life activities. Individuals age 21 and over shall meet all of the following criteria in order to be eligible to receive MHSS:
1. The individual shall have one of the following as a primary mental health diagnosis:
a) Schizophrenia or other psychotic disorder as set out in the DSM-5,
b) Major Depressive Disorder;
c) Bipolar I or Bipolar II;
d) Any other serious mental health disorder that physician has documented specific to the identified individual within the past year that
includes all of the following: (i) is a serious mental illness; (ii) results in severe and recurrent disability; (iii) produces functional limitations in the individual’s major life activities that are documented in the individual’s medical record, AND; (iv) the individual requires individualized training in order to achieve or maintain independent living in the community.
2. The individual shall require individualized goal directed training in order to acquire or maintain self-regulation of basic living skills such, as symptom management; adherence to psychiatric and physical health medication treatment plans; appropriate use of social skills and personal support system; skills to manage personal hygiene, food preparation, and the maintenance of personal adequate nutrition; money management; and use of community resources.
3. The individual shall have a prior history of any of the following: (i) psychiatric hospitalization; (ii) either residential or non residential crisis stabilization, (iii) ICT or Program of Assertive Community Treatment (PACT) services; (iv) placement in a psychiatric residential treatment facility as a result of decompensation related to the individual’s serious mental illness; or (v) a temporary detention order (TDO) evaluation pursuant to the Code of Virginia §37.2-809(B). This criterion shall be met in order to be initially admitted to services, and not for subsequent authorizations of service. Discharge summaries from prior providers that clearly indicate (i) the type of treatment provided, (ii)
the dates of the treatment previously provided, and (iii) the name of treatment provider shall be sufficient to meet this requirement. Family member statements shall not suffice to meet this requirement.
4. The individual shall have had a prescription for antipsychotic, mood stabilizing, or antidepressant medications within the 12 months prior to the Comprehensive Needs Assessment. If a physician or other practitioner who is authorized by his license to prescribe medications indicates that anti-psychotic, mood stabilizing, or antidepressant medications are medically contraindicated for the individual, the provider shall obtain medical records signed by the physician or other licensed prescriber detailing the contraindication. This documentation shall be maintained in the individual’s MHSS record, and the provider shall document and describe how the individual will be able to actively participate in and benefit from services without the assistance of medication. This criterion shall be met upon admission to services, and not for subsequent authorizations of service. Discharge summaries from prior providers that clearly indicate (i) the type of treatment provided, including psychiatric medication history, (ii) the dates of the treatment previously provided, and (iii) the name of treatment provider shall be sufficient to meet this requirement. Family member statements shall not suffice to meet this requirement. Individuals 18-20 years shall meet all of the above medical necessity criteria listed in paragraphs 1 through 2 (A-D) in order to be eligible to receive MHSS and the following:
5. The individual shall not be in a supervised setting as described in §63.2-905.1 of the Code of Virginia. If the individual is transitioning into an independent living situation, services shall only be authorized for up to six months prior to the date of transition. Individuals eligible for this service may have a dual diagnosis of either mental illness and developmental disability or mental illness and substance use disorder. If an individual has co-occurring mental health and substance use disorders, integrated treatment for both disorders is allowed within MHSS as long as the treatment for the substance use disorder is intended to positively impact the mental health condition. The impact of the substance use disorder on the mental health condition must be documented in the Comprehensive Needs Assessment, the ISP, and the progress notes.
Individuals eligible for this service may have a dual diagnosis of either mental illness and developmental disability or mental illness and substance use disorder. If an individual has co-occurring mental health and substance use disorders, integrated treatment for both disorders is allowed within MHSS as long as the treatment for the substance use disorder is intended to positively impact the mental health condition. The impact of the substance use disorder on the mental health condition must be documented in the Comprehensive Needs Assessment, the ISP, and the progress notes.
Residential Crisis Stabilization Unit (RCSU)
RCSUs provide short-term, 24/7, residential psychiatric/substance related crisis evaluation and brief intervention services. Residential Crisis Stabilization Units (RCSUs) serve as diversion or stepdown from inpatient hospitalization. The service supports individuals experiencing abrupt and substantial changes in behavior noted by severe impairment or acute decompensation in functioning.
Critical Features & Service Components
This service occurs in a non-hospital, community-based crisis stabilization residential unit. RCSUs serve as primary alternatives to inpatient hospitalization for individuals who are in need of a safe, secure environment for assessment and crisis treatment. RCSUs also serve as a stepdown option from psychiatric inpatient hospitalization and function to stabilize and reintegrate individuals who meet medical necessity criteria back into their communities. RCSUs may co-locate with 23 Hour Crisis Stabilization.
Critical Features/Covered Service Components of RCSUs include:
- Assessment
- Treatment planning;
- Health literacy counseling/Psychoeducation;
- Skills restoration;
- Peer recovery support services
- Medical and nursing assessments and care;
- Individual, group and/or family therapy;
- Care coordination
- Psychiatric evaluation
- Crisis intervention
Residential Crisis Stabilization Medical Necessity Criteria
Individuals must meet all of the following criteria:
- Documentation indicates evidence that the individual meets criteria for a primary diagnosis consistent with the most recent version of the Diagnostic and Statistical Manual
- One of the following must be present:
1.) The individual is currently under a Temporary Detention Order;
2.) Abrupt and substantial changes in behavior noted by severe impairment or acute decompensation in functioning related to a behavioral health problem;
3.) Actual or potential danger to self or others as evidenced by:
a.) Suicidal thoughts or behaviors and/or recent self-injurious behavior with suicidal intent; or
b.) Homicidal ideation; or
c.) Command hallucinations or delusions
4.) Significant loss of impulse control that threatens the safety of the individual and/or others or their ability to take care of themselves;
5.) Significant inability to maintain basic care for oneself and to keep oneself safe in the community in an age appropriate manner that is not associated with Dementia;
6.) Substance intoxication with suicidal/homicidal ideation or inability to care for self
Exclusion Criteria
Any one of the following criteria is sufficient for exclusion from this level of care:
1. The individual’s psychiatric condition is of such severity that it can only
be safely treated in an inpatient setting due to violent aggression or other anticipated need for physical restraint, seclusion or other involuntary control; or
- The individual’s medical condition is such that it can only be safely treated in a medical hospital as deemed by a physician; or
- The individual does not voluntarily consent to admission with the exception of temporary detention orders pursuant to §37.2-800 et. seq. and §16.1-335 et seq. of the Code of Virginia;
- The individual can be safely maintained and effectively participate in a less intensive level of care; or
- The request for service authorization is being pursued to address a primary issue of housing need, including individuals who were in some form of housing placement prior to admission to the RCSU and are not currently allowed to return and do not meet medical necessity criteria; or
- Admission does not meet medical necessity criteria and is being used solely as an alternative to incarceration.
Substance Abuse
The Substance Abuse Outpatient Program provides comprehensive rehabilitation services to adults who require a structured treatment environment to address specific behaviors/ issues associated with or manifesting from substance use disorders.
- Partial Hospitalization Services (ASAM Level 2.5) is a structured program of skilled treatment services for adults delivering a minimum of 20 hours per week and at least five service hours per service day of skilled treatment services with a planned format including individual and group counseling, medication management, family therapy, education groups, occupational and recreational therapy, and other therapies. Withdrawal management services may be provided as necessary.
- Intensive Outpatient treatment (IOP) (ASAM Level 2.1) is a structured program of skilled treatment services for adults delivering a minimum of 3 service hours per service day to achieve an average or 9 to 19 hours of services per week.
Aftercare services are also available to those individuals who have completed outpatient treatment program. In an effort to provide client-centered services that will be most beneficial to the individuals, the Outpatient Program employs a number of Evidence-Based Practices (EBPs) in its treatment approach.
Program Curriculum
The Outpatient Program curriculum focuses on all aspects of chemical abuse/dependency, recovery, and relapse prevention. A schedule of group therapy, educational and support groups, and individual and family interventions is utilized in the structured, non-residential treatment modality. The curriculum includes Substance Use Disorder and Health Education, Growth and Recovery discussion groups, and Relapse Prevention as primary areas of concentration. The Matrix model is a manual approach covering SA education, relationships, triggers, and effective decision making. Consumers will develop constructive support networks, and social/recreational strengths and resources. Groups are dynamically structured to maximize the consumer’s opportunity to practice new coping skills and to work in enhancing their level of competency and comfort in the areas of communication, development of appropriate boundaries, trust levels, and acceptance of self and others.