STANDARDS TRAINING CCS VS. STAD 106

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STANDARDS TRAININGCCS VS. STAD

1/06
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2005 MEDICAID STANDARDS DEFINITION
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Standard DescriptionTarget Population
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TREATMENT FOCUS
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TREATMENT FOCUS(CONT)
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TREATMENT FOCUS (CONT)
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STAFF QUALIFICATIONS
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DOCUMENTATION REQUIREMENTS
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FREQUENCY,UNITS AND RELATIONSHIP TO OTHER SERVICES
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CASE EXAMPLE 1

• CCS OR STAD?
• 1. 30 year old man with 11 year history of
  schizophrenia. He is living independently. Med
  compliant, 3 hospitalizations within the last 1
  year. Some baseline symptoms present
  (hallucinations). Has the ability to perform many
  tasks independently but upon home visits it is
  apparent that he has trouble completing all steps
  in a task and initiating behaviors on his own. He
  is not interacting socially with others nor has
  he worked at a job in 11 years. No glaring safety
  hazards were observed in the apartment but items
  were strewn haphazardly, it was dirty. He is
  brushing his teeth less than 1 time per week, his
  clothing were soiled and overall he appeared
  unkempt.

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• CCS as a starting point
• With continued assessments look for possibly
  changing services to STAD, PRS, or even Group
  Therapy

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CASE EXAMPLE 2

• CCS OR STAD?
• 2. 43 year old living in a CRCF. 20
  hospitalizations over a 4 year period. Somatic
  delusions, tangential speech and auditory
  hallucinations. Wearing inappropriate clothing
  for season, poor kitchen and overall safety
  skills. Not engaging in leisure activities. Able
  to initiate behavior but easily distracted and
  driven by environmental clues. Moderate med
  compliance. Unable to attend to majority of ADLs

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• CCS would be appropriate with this client

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CASE EXAMPLE 3

• 3. 53 year old diagnosed with Schizoaffective
  Disorder. Some history of working documented. 4
  years ago decompensated and attempted to stab
  mental Health counselor. Released from Legal
  Offender unit of state hospital 6 months ago.
  Living in CRCF. Stable and compliant on meds. No
  leisure activities, no significant relationships,
  low level of depression and general lack of
  interest in daily activities. Able to attend to
  ADLs but often chooses not to follow through
  with these

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• This client could receive either CCS or STAD (but
  never both)
• With either service continued assessment of
  progress and appropriateness would be recommended
  to ensure services are appropriate

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CASE EXAMPLE 4

• CCS OR STAD?
• 4. 65 year old with full scale IQ of 72. He is
  obese, incontinent and suffers additional medical
  ailments. DX is PTSD from severe childhood abuse
  as well as Axis II Borderline Intellectual
  Functioning He is unable to maintain his own
  hygiene and needs assistance with majority of
  ADLs. he is often agitated and non-compliant
  with medication and treatment.

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• CCS would be appropriate for this client
• Borderline Intellectual functioning needs to be
  taken into consideration when evaluating this
  client for appropriate services

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CASE EXAMPLE 5

• CCS OR STAD?
• 5. 36 year old with Psychosis NOS. He has a
  history of polysubstance abuse and episodic
  psychotic symptoms. Long history of incarceration
  and violence. Released from jail 2 weeks ago,
  stable and compliant with meds, some insight into
  his illness evident, living in boarding home.
  Able to attend to daily ADLs but often chooses
  not to shower or change clothes for several days
  and when approached about this he will comply but
  needs frequent reminders. He is not capable of
  working right now due to lack of appropriate
  vocational skills.

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• STAD
• Diagnosis needs to be re-evaluated
• AD issues need to be taken into consideration
• Substance induced psychosis?

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