Residential Support Services

Community Residential Rehabilitation (CRR)

This service provides four levels of support and service intensity which are medically required by an adult to remain in a community-based residence.  The goals of the service are to restore and develop skills in functional areas which interfere with consumer’s ability to live in the community, to support the person to live independently, and to support the person to independently participate in social, interpersonal or community activities. 

Activities that are considered necessary to remain in the community include, but are not limited to: supporting housing retention (such as crisis coping skills, dispute resolution and peer mentoring);  building and maintaining independent living skills (such as meal planning and preparation, household cleaning, shopping, budgeting, community resource access and utilization and wellness, recreational and social activities); providing support to access and attend mental health, medical, dental and substance abuse appointments and treatment; providing support to access and follow – through with medical and nonmedical transportation; to develop and support the maintenance of social relationships which provide natural supports to prevent escalation of symptoms into  crisis situations; and monitoring and/ or directly providing personal care services.  All recovery-building activities are intended to support successful community living through utilization of skills training, cuing and/ or guided supervision as identified in the person-centered service plan.

This service does not include care or treatment in an Institute for Mental Diseases.  Services are provided in the community or in the person’s residence which may be his/her own home, personal care home, or another community living situation.  Provider qualifications to provide these services are ensured by provider compliance with requirements and standards of the national accreditation Commission on accreditation for Rehabilitation Facilities (CARF), which specifically accredits rehabilitative Provider Agencies in the areas of behavioral health community services.  Providers are required to meet all applicable licensure requirements, hold a current license, and, for practitioners, adhere to scope of practice definitions of licensure/certification boards.

CRR Level I is intensive and provides 24/7/365 awake staff support generally in a licensed community-living setting (in no case exceeding 16 beds).  In order to directly support the individual, there will be a minimum of five hours weekly of skills training, community integration activities, and or personal services provided to the person if indicated on the individual supports plan. This skills training is provided by one or more Community Living.  Supports specialists who may be practitioner Level 3, 4 or 5.

CRR Level II is intensive and provides 24/7/365 staff supports generally in a licensed community-living setting (in no case exceeding 16 beds).  In order to directly support the individual, there will be a minimum of five hours weekly of skills training, community integration activities, and/or personal services provided to the person if indicated on the individual supports plan.  This skills training is provided by one or more Community Living Supports specialists who may be practitioner Level 3, 4 or 5.

CRR Level III is semi-independent support which provides 36 hours per week staff support generally in a licensed community-living setting (in no case exceeding 16 beds). In order to directly support the individual, there will be a minimum of three hours per week of skills training, community integration activities, and/or personal services provided to the person if indicated on the individual supports plan.  This skills training is provided by one or more Community Living Supports specialists who may be practitioner Level 4 or 5.

CRR Level IV is support to provide a minimum of one face-to-face contact and an average of 10 15-minute units per week of skills training, community integration activities, and/or personal services provided to the person as indicated on the individual supports plan.  A Community Living Supports specialist is a practitioner Level 5 operation on 65% productivity and  is on call and available to consumers 24/7/365.  This skills training is provided by one or more Community Living Supports specialists who may be practitioner Level 4 or 5.

Resources

DBHDD Housing Need and Choice Evaluation Memo

Encounter Reporting Mental Health Residential Services

Housing First and Harm Reduction

Housing for People with Developmental Disabilities and Behavioral Health Needs: A White Paper from DBHDD

Medicaid State Plan Amendment: Community Residential Rehabilitation

Medicaid and Permanent Supportive Housing for Chronically Homeless Individuals: Emerging Practices from the Field

Promoting Community Integration Through Housing First & Housing Based Services

Supported Housing Needs and Choice Evaluation (DBHDD Policy #01-120)

Supported Housing Need and Choice Evaluation Web Access 

Transforming to a Housing First Framework

What is Recovery?