Section 440 IAC 4.3-1-1 - DefinitionsAuthority: IC 12-21-2-3; IC 12-21-2-8; IC 12-21-5-1.5
Affected: IC 12-7-2; IC 12-21-2-7; IC 23-17; 42 U.S.C. 300x-2(c)
Sec. 1.
The following definitions apply throughout this article:
(1) "Accreditation" means that an accrediting agency has determined that the entity has met the requirements of the accrediting agency.(2) "Accrediting agency" means an organization, included on a list of accrediting organizations approved by the division, that:(A) has developed standards for agencies providing behavioral health care or agencies that arrange to provide behavioral health care through a network or integrated delivery system; and(B) evaluates compliance with the established standards on a regularly scheduled basis.(3) "Addiction services" means a structured program designed for the treatment, care, or rehabilitation of individuals who abuse alcohol or drugs.(4) "Alcohol abuse" means repeated episodes of intoxication or drinking that impair the individual's health or interfere with the individual's effectiveness on the job, at home, in the community, or in operating a motor vehicle.(5) "Certification" means the process used by the division to document a provider's compliance with the statutory and regulatory requirements for contracting with the division as a managed care provider, including issuance of a certificate if the provider is found to comply with the applicable requirements in this article.(6) "Community mental health center" or "CMHC" means a mental health facility that the division has certified as fulfilling the statutory and regulatory requirements to be a community mental health center.(7) "Consumer" means an individual who has received or is receiving mental health or addiction services.(8) "Continuum of care" means a range of services the provision of which is assured by a managed care provider. The term includes the following: (A) Individualized treatment planning to increase patient coping skills and symptom management, which may include any combination of services listed in this subdivision.(B) Twenty-four (24) hour a day crisis intervention.(C) Case management to fulfill individual patient needs, including assertive case management when indicated.(D) Outpatient services, including the following: (i) Intensive outpatient services. (ii) Substance abuse services.(iii) Counseling and treatment.(E) Acute stabilization services, including detoxification services.(F) Residential services.(H) Family support services.(I) Medication evaluation and monitoring.(J) Services to prevent unnecessary and inappropriate treatment and hospitalization and the deprivation of a person's liberty.(9) "Division" means the division of mental health.(10) "Drug abuse" means the development of a psychological or physical dependence on the effect of drugs or harmful substances so that the individual or society is harmed or endangered.(11) "Managed care provider" means an organization:(A) that: (i) for mental health services, is defined under 42 U.S.C. 300x-2(c); or (ii) provides addiction services;(B) that has entered into a provider agreement with the division under IC 12-21-2-7 to provide a continuum of care in the least restrictive, most appropriate setting; and(C) that is operated by at least one (1) of the following:(i) A city, town, county, or other political subdivision of Indiana. (ii) An agency of Indiana or of the United States.(iii) A political subdivision of another state.(iv) A hospital owned or operated by:(AA) a unit of government; or(BB) a building authority that is organized for the purpose of constructing facilities to be leased to units of government. (v) A corporation incorporated under IC 23-7-1.1 (before its repeal August 1, 1991) or IC 23-17. (vi) A nonprofit corporation incorporated in another state.(vii) A university or college.(12) "Provider agreement" means a properly executed contract to provide services.(13) "Subcontract" means any contract established between:(A) the managed care provider and another entity; or(B) a subcontractor and another entity; to provide financial services, administrative services, or one (1) or more services as a part of the continuum of care.Division of Mental Health and Addiction; 440 IAC 4.3-1-1; filed Oct 11, 1996, 2:00 p.m.: 20 IR 753; errata, 20 IR 959; filed Mar 13, 2000, 7:44 a.m.: 23 IR 1985; readopted filed May 10, 2001, 2:30 p.m.: 24 IR 3235; readopted filed Apr 7, 2008, 3:40 p.m.: 20080507-IR-440070745RFA; Readopted filed 8/11/2014, 11:21 a.m.: 20140910-IR-440140240RFAReadopted filed 11/9/2020, 3:09 p.m.: 20201209-IR-440200502RFA