i-CORT

The Intensive Community Outreach and Recovery Team (I-CORT) I-CORT is a recovery and resiliency oriented, intensive, community-based rehabilitation and outreach service for adults with a severe and persistent mental illness. It is a team-oriented approach to mental health rehabilitation intervention and supports necessary to assist individuals in achieving and maintaining rehabilitative, resiliency and recovery goals.

I-CORT services are provided primarily in natural settings and are delivered face to face, by phone or video conference with the individual and their family/significant other as appropriate, to the primary well-being and benefit of the recipient. I-CORT assists in the setting and attaining of individually defined recovery/resiliency goals. I-CORT primary treatment objective is to assist in keeping the individuals receiving the service in the community in which they live avoiding placement in state-operated behavioral health programs.

Admission Requirements:

In order to be admitted into I-CORT services, individuals must meet the criteria outlined in this rule:

I-CORT only serves individuals with severe and persistent mental illness as listed in the most current edition of the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association which seriously impairs their functioning in community living.

Priority is given to people with schizophrenia, other psychotic disorders (e.g., schizoaffective disorder), and bipolar disorder because these illnesses more often cause long-term psychiatric disability.

Individuals with other psychiatric illnesses are eligible, dependent on the level of the long-term disability. However, (Individuals with a primary diagnosis of a substance abuse disorder, an intellectual disability, or personality disorders are not the intended individuals. Additionally, individuals with a chronically violent history may not be appropriate for this service.

Individuals with significant functional impairments as demonstrated by at least one of the following conditions:

Significant difficulty consistently performing the range of practical daily living tasks required for basic adult functioning in the community (e.g., caring for personal business affairs; obtaining medical, legal, and housing services; recognizing and avoiding common dangers or hazards to self and possessions; meeting nutritional needs; maintaining personal hygiene) or persistent or recurrent difficulty performing daily living tasks except with significant support or assistance from others such as friends, family, or relatives.

Significant difficulty maintaining consistent employment at a self-sustaining level or significant difficulty consistently carrying out the homemaker role (e.g., household meal preparation, washing clothes, budgeting, or child-care tasks and responsibilities).

Significant difficulty maintaining a safe living situation (e.g., repeated evictions or loss of housing).

Individuals with one or more of the following problems, which are indicators of continuous high-service needs (i.e., greater than eight hours per month).

High use of acute psychiatric hospitals (e.g., two or more admissions per year) or psychiatric emergency services (i.e., extensive use of Mobile Crisis Response Team services).

Intractable (i.e., persistent, or very recurrent) severe major symptoms (e.g., affective, psychotic, suicidal).

Coexisting substance abuse disorder of significant duration (e.g., greater than 6 months).

High risk or recent history of criminal justice involvement (e.g., arrest, incarceration) due to behavioral problems attributed to the person's mental illness.

Significant difficulty meeting basic survival needs, residing in substandard housing, homelessness, or imminent risk of becoming homeless.

Residing in an inpatient or supervised community residence, but clinically assessed to be able to live in a more independent living situation if intensive services are provided or requiring a residential or institutional placement it more intensive services are not available.

Difficulty effectively utilizing traditional office-based outpatient services (i.e., office-based individual and/or group therapy, psychosocial rehabilitation, and medication monitoring.)

Additional Information:

I-CORT will provide peer support services, individual mental health therapy, medication administration/monitoring, general health care monitoring/treatment, supportive counseling, social/hygiene skills training, recovery/resiliency support, symptom management, budgeting skills and leisure time activities.

I-CORT services must be provided as follows:

• 24 hours per day and 7 days per week (after normal work hour's on-call services can be

rotated among the I-CORT staff). I-CORT can also utilize the MCeRT team for

assistance with on-call but the response to a crisis by an individual enrolled in I-CORT

must be by a staff from the I-CORT team.

• Seventy-five percent of I-CORT work time must be in a community setting. Individuals

that can make and maintain appointments at a clinic should not qualify for I-CORT

services. I-CORT is for individuals with intensive needs that traditional outpatient

clinic services have not been successful.

• Each individual can receive services as often as necessary but at a minimum they must

be seen two times a week at a minimum of two hours (total).

• Each staff person must provide services to each individual as often a therapeutically

necessary but at a minimum each staff must provide services to each individual one

time a week.

• Each individual must receive services from a psychiatrist or psychiatric nurse

practitioner as often as necessary but at a minimum of one time per every 30 days.

These services can be provided in an office or community setting. I-CORT staff must

facilitate and provide transportation (if necessary) to the appointment.

• Seventy-five percent of I-CORT service contacts to the individual served must be in

the community (non-office based or non-facility-based settings).