Current through Register 1538, January 3, 2025
Section 425.406 - Admission Criteria for Members Younger than 21 Years Old(A) A screening team must screen a member younger than 21 years old prior to admission to a psychiatric inpatient hospital or prior to conversion to MassHealth, as defined in 130 CMR 425.402. The screening team will determine and certify whether the admission is medically necessary.(B) To demonstrate the necessity of a psychiatric inpatient hospital admission for a member younger than 21 years old, the following conditions must be met: (1) the member must have mental illness;(2) the member must meet one or more of the following criteria:(a) be dangerous to himself or herself;(b) be dangerous to others; or(c) be unable to care for himself or herself; and(3) the moment-to-moment medical observation or clinical management required cannot be provided in a less restrictive setting.(C) Court-ordered admissions are exempt from the admission criteria stated in 130 CMR 425.406(A) and (B).Amended by Mass Register Issue 1341, eff. 6/16/2017.