23 Miss. Code. R. 206-1.2

Current through October 31, 2024
Rule 23-206-1.2 - Definitions

The Division of Medicaid defines:

A. Assessment as obtaining from the beneficiary, beneficiary's family or others involved in the beneficiary's care, the beneficiary's family background/ educational/vocational achievement, presenting problem(s), problem history, history of previous treatment, medical history, current medication(s), source of referral and other pertinent information in order to determine the nature of the beneficiary's or family's problem(s), the factors contributing to the problem(s), and the most appropriate course of treatment for the beneficiary.
B. Acute Partial Hospitalization as a program that provides medical supervision, nursing services, structured therapeutic activities and intensive psychotherapy (individual, family and/or group) to beneficiaries who are experiencing a period of such acute distress that their ability to cope with normal life circumstances is severely impaired. Acute Partial Hospitalization is designed to provide an alternative to inpatient hospitalization for such beneficiaries or to serve as a bridge from inpatient hospital to outpatient hospital or community treatment. Program content may vary based on beneficiary need but must include close observation/supervision and intensive support with a focus on the reduction/elimination of acute symptoms.
C. A Brief Emotional/Behavioral Health Assessment as a brief screening used to assess a beneficiary's emotional and/or behavioral health and covers a variety of standardized assessments aimed to identify the need for more in-depth evaluation for a number of mental/behavioral conditions.
D. Clinical Staff member as a staff member who holds, at a minimum, a master's degree and professional license or who is a DMH Certified Mental Health Therapist (CMHT), DMH Certified Intellectual and Developmental Disabilities Therapist (CIDDT) or a DMH Certified Addiction Therapist (CAT) when appropriate.
E. Community Support Services as services that are specific, measurable, and individualized that focus on the mental health needs of the beneficiary while attempting to restore beneficiary's ability to succeed in the community.
1. Identification of strengths which aid the beneficiary in their recovery and the barriers that will challenge the development of skills necessary for independent functioning in the community.
2. Individual therapeutic interventions that directly increase the restoration of skills needed to accomplish the goals set forth in the Individual Service Plan.
3. Monitoring and evaluating the effectiveness of interventions that focus on restoring, retraining and reorienting, as evidenced by symptom reduction and program toward goals.
4. Psychoeducation regarding the identification and self-management of the prescribed medication regimen and communication with the prescribing provider.
5. Direct interventions in de-escalating situations to prevent crisis.
6. Relapse prevention.
7. Facilitation of the Individual Service Plan or Recovery Support Plan which includes the active involvement of the beneficiary and the people identified as important in the beneficiary's life.
F. Crisis Residential Services as medically monitored residential short-term psychiatric stabilization services provided in a setting other than an acute care hospital or a long-term residential treatment facility which consist of no more than sixteen (16) beds.
G. Crisis Response Services as time-limited intensive intervention provided by trained crisis response staff, available twenty-four (24) hours a day, seven (7) days a week and includes the assessment of the crisis and ability to activate a mobile crisis team, crisis stabilization and treatment of a beneficiary to avoid inpatient hospitalization. Crisis Response Services are limited to less than 24 hours per episode.
H. Family Therapy as face-to-face psychotherapy between a mental health therapist and a beneficiary's family members, with or without the presence of the beneficiary, which may also include others with whom the beneficiary lives or has a family-like relationship. Family Therapy includes family psychotherapy, psychoeducation, and family-to-family training.
I. Group Therapy as face-to-face psychotherapy addressing the needs of several individuals within a group.
J. Individual Therapy as face-to-face, one-on-one psychotherapy that takes place between a mental health therapist and a beneficiary.
K. Intensive Community Outreach and Recovery Team (ICORT) Services as a team-oriented assertive community treatment approach to mental health rehabilitation intervention and supports necessary to assist beneficiaries in achieving and maintaining rehabilitative, resiliency and recovery goals with a severe and persistent mental illness.
L. Interactive Complexity in:
1. Group therapy as psychotherapy using non-verbal communication and/or physical aids between a mental health therapist and no more than six (6) individuals under the age of twenty-one (21) at the same time.
2. Individual therapy as the one-on-one psychotherapy using non-verbal communication and/or physical aids between a mental health practitioner and a beneficiary who have not yet developed or have lost their expressive communication ability or do not have the cognitive ability to understand the mental health practitioner if ordinary language is used.
M. Medication Administration as the administering of a prescribed medication.
N. Medication Evaluation as regular and periodic monitoring of the therapeutic and side effects of psychotropic medications prescribed for the treatment of a mental illness.
O. Multifamily Group Therapy as therapy taking place between a licensed and enrolled provider or CMHC/PMHC staff and family members of at least two (2) different beneficiaries in a group setting.
P. Nursing assessment as an assessment of a beneficiary's psychological, physiological and sociological history.
Q. Peer Support Services as person-centered services with a rehabilitation and recovery focus designed to promote skills for coping with and managing psychiatric symptoms while facilitating the utilization of natural resources and the enhancement of community living skills.
R. Program of Assertive Community Treatment (PACT) as therapeutic programs provided in the community in which beneficiaries live that would traditionally need inpatient care and treatment but can be maintained in a less restrictive/community-based setting.
S. Psychiatric Diagnostic Evaluation as an integrated biopsychosocial assessment, including history, mental status, and recommendations.
T. Psychological Evaluation as the assessment of a beneficiary's cognitive, emotional, behavioral, and social functioning by a licensed psychologist using standardized tests, interviews, and behavioral observations.
U. Psychosocial Rehabilitation as an active treatment program designed to support and restore community functioning and well-being of a beneficiary who has been diagnosed with a serious and persistent mental illness by providing systematic, curriculum based interventions for skills redevelopment and to promote recovery in the beneficiary's community by alleviating psychiatric decompensation, confusion, anxiety, feelings of low self-worth, isolation and withdrawal.
V. Psychotherapeutic Services as intentional, face-to-face interactions, conversations or nonverbal encounters between a mental health therapist and a beneficiary, an individual, family or group where a therapeutic relationship is established to help resolve symptoms of the beneficiary's mental and/or emotional disturbance.
W. Quasi-governmental CMHCs are defined as entities operated under the supervision of regional commissions appointed by county boards of supervisors comprising their respective catchment areas.
X. Targeted Case Management as services furnished to assist chronically mentally ill or emotionally disturbed beneficiaries who reside in a community setting or are transitioning to a community setting, in gaining access to needed medical, social, educational, and other services
Y. Treatment Plan as the plan that directs the treatment of the beneficiary and may be referred to as the plan of care, individualized service plan, wraparound plan or person-centered plan depending on the services provided.
Z. Treatment Plan Development and Review as the development and review of an overall treatment plan that directs the treatment and support of the person receiving services by qualified mental health providers.

23 Miss. Code. R. 206-1.2

42 C.F.R. §§ 440.130, 440.169; Miss. Code Ann. §§ 43-13-117, 43-13-121.
Amended 9/1/2020
Amended 11/1/2020
Amended 7/1/2021