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(1) "Adult" means a person who is not a child or adolescent as defined in this rule.

(2) "Adult day treatment" means a program which provides, in accordance with mental health center license requirements, a variety of mental health services to adults with severe disabling mental illness.

(3) "Child or adolescent" means a person 17 years of age and younger or a person who is under 20 years of age and is enrolled in secondary school.

(4) "Child and adolescent day treatment" means a program which provides, in accordance with mental health center license requirements, an integrated set of mental health, education, and family intervention services to children or adolescents with severe emotional disturbance.

(5) "Community based psychiatric rehabilitation and support" means services provided in home, school, workplace, and community settings for adults with severe and disabling mental illness and youth with serious emotional disturbance. Services are provided by trained mental health personnel under the direction of and according to individualized treatment plans prepared by licensed professionals. The services are provided outside of normal clinical or mental health program settings and are designed to assist individuals in developing the skills, behaviors, and emotional stability necessary to live successfully in the community. Community based psychiatric rehabilitation and support services are provided on a face-to-face basis with the recipient, family members, teachers, employers or other key individuals in the recipient's life when such contacts are clearly necessary to meet goals established in the recipient's individual treatment plan.

(a) Community based psychiatric rehabilitation and support includes but is not limited to the following services:

(i) evaluation and assessment of symptomatic, behavioral, social and environmental barriers to independent living and community integration;

(ii) assisting the consumer to develop communication skills, develop self-management of psychiatric symptoms, and develop social networks necessary to minimize social isolation and increase opportunities for a socially integrated life;

(iii) assisting the consumer to develop daily living skills and behaviors necessary for maintenance of a home and family, an appropriate education, employment or vocational situation, and productive leisure and social activities;

(iv) immediate intervention in a crisis situation and referral to necessary and appropriate care and treatment.

(b) Community based psychiatric rehabilitation and support does not include the following services:

(i) interventions provided in day treatment or partial hospitalization programs;

(ii) interventions provided in a hospital, nursing home, or residential treatment facility;

(iii) interventions provided by staff of crisis facilities, group homes, or therapeutic foster care providers in such facilities, homes, or settings;

(iv) services provided as part of the recipient's intensive case management plan;

(v) therapeutic interventions by licensed practitioners, regardless of the location of the service;

(vi) activities which are purely recreational in nature; and

(vii) services provided within the school classroom that are educational, including, but not limited to educational aides.

(6) "Community mental health center" means a licensed mental health center, governed by a regional mental health corporation board created by 53-21-204 , MCA, that provides the comprehensive mental health services listed in 53-21-201 (1), MCA.

(7) "Crisis intervention services" means a program which provides, in accordance with mental health center license requirements, emergency short term 24-hour care, treatment and supervision in a crisis intervention stabilization facility for persons age 18 or older with mental illness experiencing a mental health crisis.

(8) "Day treatment services" means adult day treatment services and child and adolescent day treatment services.

(9) "Intensive community based rehabilitation facility" means an adult mental health group home that provides medically necessary rehabilitation services to adults with severe and disabling mental illness who have a history of institutional placements due to mental illness and a history of repeated unsuccessful placements in less intensive community based programs. The provider must provide the following services to residents:

(a) close supervision and support of daily living activities;

(b) assistance with medications including administration of medications as necessary;

(c) rehabilitation in the following areas as needed by each client:

(i) maintenance of physical health and wellness;

(ii) personal hygiene;

(iii) safety;

(iv) symptom management;

(v) communication skills;

(vi) vocational activities;

(vii) community integration;

(viii) social skills;

(ix) leisure and recreation skills;

(x) establishment and maintenance of a community support network;

(xi) establishment and maintenance of meaningful daily structure; and

(xii) management of personal finances;

(d) case management to assure all necessary community services and supports, including services and supports for non-psychiatric medical conditions, are available;

(e) discharge planning for transition to a less restrictive setting when appropriate; and

(f) transportation to assure appropriate community resources are accessible.

(10) "Foster care for mentally ill adults" means a supervised living environment in a licensed foster home with support services by mental health professionals.

(11) "In-training practitioner services" are services provided under the supervision of a licensed practitioner by an individual who has completed all academic requirements for licensure as a psychologist, clinical social worker or licensed professional counselor and is in the process of completing the supervised experience requirement for licensure. The in-training practitioner's services must be supervised by a licensed practitioner in the same field, and, other than licensure, the services are subject to the same requirements that apply to licensed practitioners.

(12) "Mental health center services" means child and adolescent day treatment services, adult day treatment services, community based psychiatric rehabilitation and support respite care, in-training practitioner services and the therapeutic component of crisis intervention services, foster care for mentally ill adults and mental health group home services and programs of assertive community treatment, as defined in these rules.

(13) "Mental health group home services" means a supported living environment provided under a group home endorsed mental health center license and providing independent living and social skills development services.

(14) "Program of assertive community treatment" means a self-contained clinical team which:

(a) provides needed treatment, rehabilitation and support services to identified clients with severe disabling mental illness;

(b) minimally refers clients to outside service providers;

(c) provides services on a long term basis;

(d) delivers 75% or more of team service time outside program offices;

(e) serves individuals with severe disabling mental illness (SDMI) who are at least 18 years old, have severe symptoms and impairments not effectively treated by other available, less intensive services, or who have a history of avoiding mental health services;

(f) provides psychiatric services at the rate of at least 20 hours per week for each 70 persons served; and

(g) maintains a ratio of at least one staff person, not including the psychiatrist, for each nine persons served. Assertive community treatment teams must be approved by the addictive and mental disorders division.

(15) "Practitioner" means a physician, mid-level practitioner, licensed psychologist, licensed clinical social worker or licensed professional counselor.

(16) "Practitioner services" means services provided by a practitioner which could be covered and reimbursed by the Montana Medicaid program if the individual practitioner were enrolled in the program and provided the services according to applicable Medicaid requirements.

(17) "Respite care" means relief services that allow family members, who are regular care givers for an adult with severe disabling mental illness or a youth with serious emotional disturbance, to be relieved of their care giver responsibilities for a temporary, short term period.

(18) "Treatment day" means a calendar day, including night, daytime or evening, during which a patient is present at the provider's facility and receiving services according to applicable requirements.

History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA; NEW, 1999 MAR p. 1301, Eff. 7/1/99; TRANS, from SRS, 2000 MAR p. 195; AMD, 2001 MAR p. 27, Eff. 1/12/01; AMD, 2002 MAR p. 2225, Eff. 8/16/02; AMD, 2004 MAR p. 84, Eff. 1/1/04; AMD, 2007 MAR p. 1197, Eff. 8/24/07.

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