| Behavioral Health Rehabilitation Services (BHRS) |
BHRS are treatment and therapeutic interventions prescribed by a psychologist or psychiatrist provided on an individual basis in the person's own environment such as the home, school and community. These services include Therapeutic Support Staff (TSS), Behavioral Specialist Consultants (BSC), Mobile Therapy (MT) and specialized services, as approved.
When submitting a packet, 6 items are required: the Best Practices Evaluation, the Individual Treatment Plan, and the 4 forms that are labeled *required for packet submission below. |
| Evaluation Authorization Request |
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| TSS Schedule Forms (All Counties) |
| Sample TSS Schedule Form | TSS Schedule Form and Directions | Final TSS Schedule Form (*required for packet submission) |
| Life Domain BP Format for Evaluations |
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All Counties |
| Prescriber Responsibilities if Using Assistants for Evaluations |
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All Counties |
| Guidelines for Addendums to Evaluations |
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All Counties |
| Prescriber Responsibilities at ISPT |
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All Counties |
| BHRS Plan of Care Form and Directions |
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(*required for packet submission)
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| MST and FFT Plan of Care Form and Directions |
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(*required for packet submission when submitting MST and FFT Packet)
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| ISPT Sign In, Confidentiality Statement, Summary and Prescriber Collaboration |
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All Counties (*required for packet submission) |
| Family Choice Notification |
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(*required for packet submission)
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| Discharge Checklist and Summary |
| All Counties |
| FBA Certification Update |
| All Counties |
