Code of Massachusetts Regulations › 130 CMR - DIVISION OF MEDICAL ASSISTANCE › Title 130 CMR 429.000 - Mental Health Center Services › Section 429.402 - Definitions

Current through Register 1525, July 5, 2024
The following terms used in
				130 CMR
				429.000 have the meanings given in
				130
				CMR 429.402 unless the context clearly
				requires a different meaning.
Adverse Incident
. An occurrence that
				represents actual or potential serious harm to the well-being of a member, or
				to others under the care of the mental health center. Adverse incidents may be
				the result of the actions of a member served, actions of a staff member
				providing services, or incidents that compromise the health, safety, or
				operations of the center.
Behavioral Health Disorder
. Any
				disorder pertaining to mental health or substance use as defined by the
Diagnostic and Statistical Manual of Mental Disorders.
Behavioral Health Urgent Care
				Provider
. A center that meets the requirements set forth in
				130
				CMR 429.405(D).
Case Consultation.
Intervention,
				including scheduled audio-only telephonic, audio-video, or in person meetings,
				for behavioral and medical management purposes on a member's behalf with
				agencies, employers, or institutions which may include the preparation of
				reports of the member's psychiatric status, history, treatment, or progress
				(other than for legal purposes) for other physicians, agencies, or insurance
				carriers.
Certified Peer Specialist (CPS).
A
				person who has been trained by an agency approved by the Department of Mental
				Health (DMH) who is a self-identified person with lived experience of a mental
				health disorder and wellness that can effectively share their experiences and
				serve as a mentor, advocate, or facilitator for a member experiencing a mental
				health disorder.
Child and Adolescent Needs and Strengths
				(CANS)
. A tool that provides a standardized way to organize
				information gathered during behavioral-health clinical assessments. A
				Massachusetts version of the tool has been developed and is intended to be used
				as a treatment decision support tool for behavioral-health providers serving
				MassHealth members younger than 21 years old.
Communication Protocol.
Formal
				descriptions of requirements that allow two or more providers to exchange
				information.
Core Discipline
. Licensed behavioral
				health disciplines, including but not limited to: psychiatry, social work,
				psychology, or psychiatric nursing (including a psychiatric clinical nurse
				specialist), which comprise a mental health center's multidisciplinary
				staff.
Couple Therapy
. Psychotherapeutic
				services provided to a couple whose primary complaint is the disruption of
				their marriage, family, or relationship.
Crisis Intervention
. An urgent
				evaluation including assessment of risk, diagnosis, short-term intervention and
				rendering of a disposition for a member's presenting crisis, which may include
				referral to an existing or new behavioral health provider.
Diagnostic Evaluation Services
. The
				examination and determination of a member's physical, psychological, social,
				economic, educational, and vocational assets and disabilities for the purpose
				of designing a treatment plan.
Direct and Continuous Supervision
.
				Ongoing supervision provided to unlicensed staff and not independently licensed
				staff at a frequency of no less than one hour of supervision per week for
				full-time employees. Supervision time may be pro-rated based on scheduled hours
				for employees employed less than full-time. Direct and continuous supervision
				must be delivered by an independently licensed staff member or certified peer
				supervisor who is employed by the agency.
Enhanced Structured Outpatient Addiction Program
				(E-SOAP)
. American Society of Addiction Medicine (ASAM) Level
				Intensive Outpatient Services - a program that provides short-term, clinically
				intensive, structured day and/or evening SUD services. E-SOAP specifically
				serves specialty populations including: homeless individuals and people at risk
				of homelessness, pregnant individuals, and adolescents. E-SOAP services must
				meet requirements as set forth in
				130 CMR
				418.000:
Substance Use Disorder Treatment
				Services.
Family Consultation
. A scheduled
				meeting with one or more of the parents, legal guardian, or foster parents of a
				child who is being treated by clinical staff at the center, when the parents,
				legal guardian, or foster parents are not clients of the center.
Family Therapy
. The psychotherapeutic
				treatment of more than one member of a family simultaneously in the same
				visit.
Freestanding Clinic
. Any institution
				licensed as a clinic by the Massachusetts Department of Public Health pursuant
				to M.G.L. c. 111, § 51, that is not part of a hospital and that possesses
				its own legal identity, maintains its own patient records, and administers its
				own budget and personnel. Such institutions include mental health centers and
				community health centers.
Group Therapy.
The application of
				psychotherapeutic or counseling techniques to a group of persons, most of whom
				are not related by blood, marriage, or legal guardianship.
Individual Therapy
. Psychotherapeutic
				services provided to an individual.
Intensive Outpatient Program (IOP)
. A
				mental health treatment service that provides time-limited, multi-disciplinary,
				multimodal structured treatment in an outpatient setting for individuals
				requiring a clinical intensity that exceeds outpatient treatment. Service
				includes individual, group, and family therapy as well as case management
				services.
Medication for Addiction Treatment
.
				Use of a medication approved by the federal Food and Drug Administration (FDA),
				for the treatment of a substance use disorder.
Medication Visit
. A member visit
				specifically for the prescription, review, and monitoring of psychotropic
				medication by a psychiatrist, psychiatric clinical nurse specialist, Advanced
				Practice Registered Nurse, or Physician Assistant or administration of
				prescribed intramuscular medication by a physician. nurse, or Physician
				Assistant.
Mental Health Center (Center)
. An
				entity that delivers a comprehensive group of diagnostic and psychotherapeutic
				treatment services to individuals seeking treatment for mental health
				disorders, which may include co-occurring substance use disorder, and their
				families by an interdisciplinary team under the medical direction of a
				psychiatrist.
Mental Health Disorder
. Any disorder
				pertaining to mental health as defined by the current edition of the Diagnostic
				and Statistical Manual of Mental Disorders.
Multiple-family Group Therapy
. The
				treatment of more than one family unit, at the same time in the same visit, by
				one or more authorized staff member. There is more than one family member
				present per family unit and at least one of the family members per family unit
				must be an identified patient of the center.
Outreach Program
. Mental health and
				substance use disorder treatment services being delivered by a clinical or
				paraprofessional staff member of the center off the premises of the mental
				health center or any of its satellite clinics including, but not limited to,
				services in members' homes or other community environments.
Parent Clinic
. The central location of
				the mental health center, at which most of the administrative, organizational,
				and clinical services are performed.
Peer Recovery Coach.
An individual
				currently in recovery who has lived experience with substance use or other
				addictive disorders and/or co-occurring mental health disorders and has been
				trained to help their peers with a similar experience to gain hope, explore
				recovery, and achieve life goals. Peer Recovery Coaches must meet requirements
				as set forth in
				130 CMR
				418.000:
Substance Treatment
				Services.
Pharmacotherapy.
Providing therapeutic
				treatment with pharmaceutical drugs.
Physician
. An individual licensed by
				the Massachusetts Board of Registration in Medicine in accordance with M.G.L.
				c. 112, § 2.
Preventive Behavioral Health Services
.
				Short-term group interventions, recommended by a physician or other licensed
				practitioner, practicing within their scope of licensure, that cultivate coping
				skills and strategies for symptoms of depression, anxiety, and other
				social/emotional concerns, to prevent the development of behavioral health
				disorders for children and adolescents younger than 21 years old.
Psychological Testing
. The use of
				standardized test instruments to evaluate aspects of an individual's
				functioning, including aptitudes, educational achievements, cognitive
				processes, emotional conflicts, and type and degree of psychopathology, subject
				to the limitations of
				130 CMR
				411.000:
Psychologist
				Services.
Quality Management Program
. A
				systematic and ongoing process for monitoring, evaluating, and improving the
				quality and appropriateness of services provided to members, with focused
				attention on addressing cultural, ethnic, and language differences.
Recovery Support Navigator
. A
				paraprofessional specialist who receives specialized training in the essentials
				of substance use disorder and evidence-based techniques such as motivational
				interviewing, and who supports members in accessing and navigating the
				substance use disorder treatment system through activities that can include
				care coordination, case management, and motivational support.
Recovery Support Navigators
must meet requirements as
				set forth in 130 CMR 418:
Substance Use Disorder Treatment
				Services.
Release of Information (ROI)
. A
				document that allows a patient to authorize and revoke what information they
				want to release from their patient record, who it can be released to, how long
				it can be released for, and under what statutes and guidelines it is
				released.
Satellite Clinic
. A clinic at a
				different location from the parent center that operates under the license of
				and falls under the fiscal, administrative, and personnel management of the
				parent center.
Structured Outpatient Addiction Program (SOAP):
				ASAM Level Intensive Outpatient Services
a substance use disorder
				treatment service that provides short-term, multi-disciplinary, clinically
				intensive structured treatment to address the sub-acute needs of members with
				substance use disorders and/or co-occurring disorders. These services may be
				used as a transition service in the continuum of care toward lower intensity
				outpatient services or accessed directly. SOAP services must meet requirements
				as set forth in
				130 CMR
				418.000:
Substance Use Disorder Treatment
				Services
.
Substance Use Disorder
. Any disorder
				pertaining to substance use as defined by the current edition of the
Diagnostic and Statistical Manual of Mental Disorders.
Supervised Clinical Experience
. A
				clinician's experience providing diagnostic and treatment services to
				individuals, families, and groups of individuals under the direct and
				continuous supervision of a qualified independently licensed professional as
				set forth in
				130
				CMR 429.423, who is employed by the same
				agency as the supervisee.
Telehealth
. The use of synchronous or
				asynchronous audio, video, electronic media or other telecommunications
				technology, including, but not limited to:
(a) interactive audio-video
			 technology;
(b) remote patient
			 monitoring devices;
(c) audio-only
			 telephone; and
(d) online adaptive
			 interviews, for the purpose of evaluating, diagnosing, consulting, prescribing,
			 treating or monitoring of a patient's physical health, oral health, mental
			 health or substance use disorder condition.
Urgent Behavioral Health Needs
. Needs
				characterized by changes in behavior or thinking, role dysfunction, emerging
				intent of self-injury, or threats to others. Urgent behavioral health needs do
				not rise to the level of immediate risk of harm to self or
				others.