New Mexico Administrative Code › Title 7 - HEALTH › Chapter 20 - MENTAL HEALTH › Part 11 - CERTIFICATION REQUIREMENTS FOR CHILD AND ADOLESCENT MENTAL HEALTH SERVICES › Section 7.20.11.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
A. ABUSE means an
				intentional or negligent infliction of physical or psychological harm;
				intentional or negligent sexual contact or sexual exploitation; intentional or
				negligent behavior that jeopardizes life or health; torture, cruel confinement
				or corporal punishment.
B.
				ACCREDITED means written acknowledgement from a national organization that an
				agency or program meets the published standards of the organization issuing the
				accreditation.
C. ACCREDITED
				RESIDENTIAL TREATMENT CENTER (ARTC) means a facility with 16 beds or less that
				may be attached to, or housed within, a hospital or other institution; that
				provides residential treatment services pursuant to these requirements; and
				that is accredited by JCAHO.
D.
				ACTION PLAN means a written document that may be required by the licensing and
				certification authority (LCA) detailing an agency's proposed actions for
				resolving deficiencies identified by the LCA.
E. ACTIVE STATUS means a type of
				certification granted to a program currently serving clients.
F. ADMINISTRATOR means the person in charge
				of the day-to-day operation of an agency. The administrator may also be
				referred to as the director or operator.
G. ADMISSIONS HOLD means a type of sanction
				under which a program is prohibited from admitting new clients until the LCA
				determines that identified deficiencies are corrected, and lifts the
				sanction.
H. ADVANCE DIRECTIVES
				means an optional component of the comprehensive service plan. An individual
				has the right to make decisions in advance, including behavioral health
				treatment decisions, through a process called advance directive. An advance
				directive can be used to state the individual's treatment choices, preferences
				or instructions regarding pre-cursor crisis strategies, or can be used to name
				a health care agent that is someone that will make health care decisions for
				the individual. This section of the comprehensive service plan provides the
				individual the opportunity to take part in behavioral health care decisions if
				at some point in the future the individual is unable. This document allows the
				individual to express consent or refusal to medications and other health care
				decisions, including use of the seclusion and restraints.
I. AGENCY means the legally responsible
				organizational entity administering the facility or program(s) of specific
				services identified and certified pursuant to these certification
				requirements.
J. ASSISTANCE WITH
				SELF-ADMINISTRATION OF MEDICATION means the supervision and assistance given to
				a client in the self-administration of a drug.
K. BEHAVIORAL HEALTH ASSESSMENT means an
				assessment by an integrated series of procedures conducted with an individual
				to provide the basis for the development of an effective, comprehensive and
				individualized treatment plan.
L.
				BEHAVIORAL HEALTH SERVICES means services designed to meet behavioral and
				mental health and substance abuse needs of medicaid recipients in certified
				services.
M. BEHAVIOR MANAGEMENT
				means the use of basic techniques, such as reinforcement, redirection and
				voluntary time-outs to teach clients skills for managing and improving their
				own behavior; and the use of verbal de-escalation, therapeutic holds, personal
				restraint and seclusion in order to maintain a safe and therapeutic environment
				and to enhance the abilities of clients and care givers to manage client
				behavior.
N. BEHAVIOR MANAGEMENT
				SKILLS DEVELOPMENT SERVICES (BMS) means services provided on a staff-to-child
				ratio of at least 1:1. Behavior management skills development services are for
				children and adolescents with psychological, emotional, behavioral,
				neurobiological or substance abuse problems in the home, community or school
				when such problems are of such severity that highly supportive and structured
				therapeutic behavioral interventions are required. These services are designed
				to maintain the client in his/her home, community or school setting.
O. BEHAVIOR MANAGEMENT SERVICES PLAN means a
				service plan used in behavior management skills development services.
P. CANCELLATION means an LCA action
				nullifying a program's certification.
Q. CAPACITY means the maximum number of
				clients allowed to receive services in a licensed facility at any specified
				time in accordance with these certifications requirements.
R. CASE MANAGEMENT SERVICES means services
				provided in order to assist children and adolescents with identifying and
				meeting multiple and complex, special physical, cognitive and behavioral health
				care needs through planning, securing, monitoring, advocating and coordinating
				services.
S. CARF means council on
				accreditation of rehabilitation facilities.
T. CERTIFICATION means an authorized status
				conferred by the department on a program that meets these certification
				requirements for providing service(s) to children and adolescents.
U. CERTIFIED FAMILY SPECIALISTS (CFS) means
				an individual 18 years of age or older who has personal experience navigating
				any of the child or family-serving systems or advocating for family members who
				have a knowledge of and are involved with the behavioral health systems and are
				certified by an approved state of New Mexico certification program.
V. CERTIFIED PEER SPECIALISTS (CPS) means a
				self-identified current or former consumer, 18 years of age or older, of mental
				health or substance abuse services and has at least one year of mental health
				or substance abuse recovery and is certified as a CPS by an approved state of
				New Mexico certification program.
W. CHEMICAL RESTRAINT means the
				administration of a medication(s) which is neither a standard treatment for the
				client's medical or psychiatric condition nor a part of the client's daily
				medication regimen, and is used for the primary purpose of controlling a
				client's behavior or restricting a client's freedom of movement.
X. CHILD/ADOLESCENT means a person under the
				chronological age of 21 years.
Y.
				CLEARED STAFF MEMBER means an individual who has been approved by the
				department for employment in the immediate presence of children and adolescents
				by means of a state and federal criminal background clearance.
Z. CLIENT means any child or adolescent who
				receives treatment from a service certified by the department.
AA. COA means council on accreditation for
				children and family services.
AB.
				CLINICAL STAFF means licensed mental health practitioners and treatment
				coordinators.
AC. CLINICAL
				SUPERVISOR means a staff member who is a licensed independent practitioner and
				who has responsibility and authority for supervising other clinical
				staff.
AD. COMMUNITY SUPPORTS means
				the coordination of resources to individuals/families necessary for them to
				implement strategies to promote recovery, rehabilitation and
				resilience.
AE. COMMUNITY SUPPORT
				WORKER (CSW) means the primary staff responsible for assisting the client and
				family with implementation of the comprehensive service plan and coordinating
				or facilitating family and treatment team meetings and is certified by an
				approved state of New Mexico certification program.
AF. COMPREHENSIVE COMMUNITY SUPPORT SERVICES
				(CCSS) means a variety of interventions, primarily face-to-face and in
				community locations that address barriers that impede the development of skills
				necessary to independent functioning in the community. It provides assistance
				with identifying and coordinating services and supports identified in an
				individual's comprehensive service plan; supporting an individual and family in
				crisis situations; and providing individual interventions to develop or enhance
				an individual's ability to make informed and independent choices. The target
				population for CCSS includes children, youth and adults with significant
				behavioral health disorders and who meet other criteria as identified by the
				collaborative.
AG. CONTRACTOR means
				an individual who provides direct services to clients through contracts with
				the agency.
AH. CORPORAL PUNISHMENT
				means a form of discipline or behavior control that involves forced exercise or
				touching a child's body with the intent to induce pain and includes, but is not
				limited to, shaking, spanking, hitting, hair pulling, and ear
				pulling.
AI. CRIMINAL RECORDS CHECK
				(CRC) means the process of submitting state and FBI approved fingerprint cards
				and any additional required background information to the department for the
				purpose of determining whether or not an individual has state or federal
				convictions on record that may disqualify the individual from direct
				unsupervised contact with children/adolescents and, when applicable, for the
				purpose of obtaining and reviewing a record of convictions.
AJ. CRIMINAL RECORDS CLEARANCE means a
				determination made by the department, based on the results of the criminal
				records check, that an individual may work directly and unsupervised with
				children and adolescents.
AK.
				CRISIS MANAGEMENT SERVICES means those services identified in the individual's
				crisis plan. Such services are located in the community, include natural
				supports and are available to the client and family after the agency's normal
				operating hours.
AL. CRISIS PLAN
				means a component of the comprehensive service plan that clearly identifies the
				level of intensity and severity of potential crisis events and how they will be
				managed after normal business hours with specific resources identified for the
				client, family and natural supports. The crisis plan shall include defined
				client, family and treatment team roles and activities.
AM. CULTURAL COMPETENCE means the
				involvement, integration and transformation of knowledge, information and data
				about individuals and groups of people into specific clinical standards,
				service approaches, techniques and marketing programs. Cultural competence is
				illustrated by congruent behaviors, attitudes and policies that match a
				client's culture to increase the quality and appropriateness of behavioral
				health care and outcomes.
AN.
				CULTURALLY COMPETENT ASSESSMENT means the relevant cultural considerations in
				the assessment of the behavioral health needs of a client.
AO. DAY TREATMENT SERVICES (DTS) means a
				coordinated and intensive set of structured individualized therapeutic
				services, in a school, or a facility licensed by the LCA, provided for
				children, adolescents and their families who are living in the
				community.
AP. DEFICIENCY means a
				violation of, or failure to comply with, a provision(s) of these certification
				requirements.
AQ. DENIAL means a
				sanction imposed by the LCA to refuse to issue a certification, based on a
				determination made by the LCA.
AR.
				DEPARTMENT means the New Mexico children, youth and families
				department.
AS. DESIGNATED AGENCY
				means the agency that has the primary responsibility of partnering with the
				client and family for implementation of the comprehensive service
				plan.
AT. DIRECT PHYSICAL
				SUPERVISION means, with reference to criminal records clearances, either
				continuous visual observation or live video observation of a non-cleared agency
				staff member by a cleared agency staff member or by the client's legal
				guardian, while the non-cleared staff is in immediate presence of the
				client.
AU. DIRECT SERVICE STAFF
				means supervisors, physicians, nurses, therapists, client care workers,
				coordinators or other agency personnel who work in immediate direct
				unsupervised contact with children.
AV. DIRECT UNSUPERVISED CONTACT means
				physical proximity to clients, such that physical contact or abuse could occur,
				without being observed or noticed by another staff member who has been cleared
				by the department.
AW. DIRECTED
				ACTION means a formal action(s) specified by the LCA that the agency is
				required to undertake or complete in order to correct a deficiency(ies) within
				a specified time frame.
AX.
				DISCHARGE CRITERIA means specific clinically-based indicator(s) used to measure
				the client's degree of readiness for release from a given level of care stated
				in terms of achievement of treatment goals or reduction of symptoms; discharge
				criteria may also include indicators that a given level of care is
				inappropriate for a client due to such factors as dangerousness or
				non-responsiveness to treatment.
AY. DISCHARGE PLAN means a written section of
				a treatment plan/service plan and treatment plan/service plan reviews
				containing the following elements: behavioral and other clinical criteria that
				describe the conditions under which discharge will occur, identification of
				barriers to discharge; the level of care, specific services to be delivered,
				and the living situation into which discharge is projected to occur; the
				projected date of discharge, individuals responsible for implementing each
				action specified in the discharge plan, and, when indicated,
				revisions.
AZ. DISCIPLINE means
				non-abusive training that enables a client to develop self-control and orderly
				conduct in relationship to others.
BA. DOCUMENTATION means the written or
				printed record of information supporting the facts related to the certified
				services being provided to clients found in client files, personnel files, and
				other pertinent printed sources.
BB. EARLY AND PERIODIC, SCREENING, DIAGNOSIS
				AND TREATMENT (EPSDT) means periodic, comprehensive services to persons under
				21 years of age; these services are defined in the medicaid program
				policies.
BC. EMERGENCY SAFETY
				INTERVENTION means personal restraint or seclusion.
BD. EMERGENCY SANCTION means an immediate
				requirement that is imposed on a program by the LCA in response to a finding of
				health or safety deficiency(ies).
BE. EMERGENCY SERVICE means an unanticipated
				admission to an acute medical or psychiatric facility or the provision of other
				medical services by paramedics or other emergency or urgent care
				personnel.
BF. EMERGENCY SUSPENSION
				means an immediate and temporary cancellation of a certification due to an
				existing health or safety deficiency(ies), pending an appeal hearing and
				correction of health or safety deficiencies. During a period of emergency
				suspension, the medicaid provider agreement is not in effect.
BG. EMPLOYMENT HISTORY means a verifiable
				written summary of employment including names, addresses and telephone numbers
				of employers, immediate supervisors as well as dates of and explanations for
				any period(s) of unemployment for a minimum of three years immediately prior to
				hire for employment by a certified program.
BH. ENHANCED SERVICE means, in the medicaid
				managed care system, any and all services beyond the scope of the medicaid
				(fee-for-service) benefit package available to recipients in the medicaid
				managed care program.
BI.
				EXCLUSIONARY CRITERIA means agency-written criteria that define the diagnoses,
				behaviors, or conditions that preclude admission to the certified
				program.
BJ. EXEMPLARY means a
				certified status conferred by the LCA on a program that has no history of
				temporary certification, sanctions or loss of certification in the previous two
				years and meets all of the certification requirements with minor or no
				deficiencies.
BK. EXPANSION HOLD
				means a type of sanction under which an agency is prohibited from obtaining
				certification for additional services until the LCA determines that identified
				deficiencies are corrected and lifts the sanction.
BL. EXPLOITATION means the act or process of
				using a client or client's property for another person's profit, advantage or
				benefit.
BM. FACILITY means the
				physical plant and building(s) licensed by the LCA in which residential or day
				treatment mental health services are provided.
BN. FUNCTIONAL LEVEL means a determination of
				the client and as applicable, his family's, functional skills in multiple
				domains.
BO. GENERAL PROVISIONS
				means the series of certification requirements found in Sections 9 through 25
				of these certification requirements.
BP. GOVERNING BODY means the organizational
				entity of an agency that has the ultimate responsibility for all planning,
				direction, control, and management of the activities and functions of a program
				certified pursuant to these certification requirements.
BQ. GROUP HOME SERVICES (GHS) means mental
				and behavioral health services offered in a supervised, licensed facility that
				provides structured therapeutic group living for children/adolescents with
				moderate behavioral, psychological, neurobiological, or emotional problems,
				when clinical history and opinion establish that the needs of the client cannot
				be met in a less restrictive environment.
BR. HEALTH OR SAFETY DEFICIENCY means a
				deficiency that poses an immediate threat to the welfare of clients up to and
				including loss of life; physical harm; physical, sexual, psychological abuse or
				exploitation.
BS. HUMAN SERVICES
				DEGREE means an approved bachelors or masters degree from an accredited school
				in one of the following degrees: counseling and therapy, rehabilitation,
				psychology, criminal justice, social work/social services, or human
				development. If workforce issues are identified in a region of the state, the
				some other defined degrees may be considered as human services degrees.
				However, any experience required in the service definition must be met. In
				order for an agency to utilize staff with these degrees, they must submit a
				written waiver request to LCA with documentation supporting the workforce
				issues. Those alternative degrees may include nursing, sociology, public
				health, education, occupational therapy, speech and hearing sciences,
				speech-language pathology, communication sciences and disorders, gerontology,
				or social sciences.
BT. INACTIVE
				STATUS means a type of certification granted to a program that is not currently
				serving clients.
BU. INCIDENT
				REPORT means the document(s) describing a serious incident or alleged serious
				incident.
BV. INFORMAL RESOLUTION
				CONFERENCE means an informal meeting and problem-solving process between the
				department and an agency to resolve any filed or potential appeal arising from
				the imposition or potential imposition of a sanction(s).
BW. INFORMED CONSENT means a document that
				reflects that a client and the legal guardian(s) are advised of the benefits,
				risks, and alternatives of a given medication or treatment and agree to the use
				of the medication or treatment. Clients age 14 and above may consent to the use
				of a medication or treatment without the approval of their legal
				guardian(s).
BX. INITIAL
				CERTIFICATION means a type of certification granted to a program that has met
				the minimum requirements to implement a program to provide services pursuant to
				these requirements.
BY. INVESTIGATION means a formal process of inquiry used by
				  the LCA to: determine the validity of complaints or allegations made against
				  certified agencies; or to determine whether trends in incidents reported to the
				  LCA that affect the health and safety of clients are the result of negligent
				  practices, insufficient supervision of personnel or clients, or any other
				  factor that requires correction; or to determine whether or not an agency has
				  made corrective responses to resolve matters of threat to client health and
				  safety substantiated by the LCA.
BZ. JCAHO means the joint commission on
				accreditation of healthcare organizations.
CA. LICENSE means the written authorization
				issued by the LCA pursuant to 7.20.12 NMAC granting right to operate the
				designated facility for a specified period of time; or, in context, any
				necessary authorization by the appropriate credentialing authority to undertake
				the professional activity in question.
CB. LICENSED INDEPENDENT PRACTITIONER means
				New Mexico-licensed clinical staff who are authorized to practice at the
				independent level.
CC. LICENSED
				INDEPENDENT MEDICAL PRACTITIONER means a New Mexico licensed medical doctor
				(MD), doctor of osteopathy (DO), certified nurse practitioner (CNP), clinical
				nurse specialist (LCNS), or physician assistant (PA).
CD. LICENSING AND CERTIFICATION AUTHORITY
				(LCA) means the licensing and certification unit of the children's behavioral
				health and community services bureau of the prevention and intervention
				division of the department.
CE.
				MAINTENANCE OR REDUCTION IN PROGRAM CAPACITY means a sanction that directs the
				agency to maintain or reduce the capacity of the program to a designated census
				until the LCA determines that deficiencies resulting in the sanction have been
				corrected.
CF. MECHANICAL RESTRAINT
				means use of a mechanical device(s) to physically restrict a client's freedom
				of movement, performance of physical activity, or normal access to his or her
				body, and is distinct from personal restraint as defined below.
CG. MEDICAID means Title XIX of the Social
				Security Act; the joint federal-state program that pays for medical care for
				low-income persons.
CH. MONITORING
				means the ongoing review of a program's progress in correcting deficiencies.
				During a period of certification, monitoring is done at the discretion of the
				LCA. Monitoring may be implemented by means of a monitoring plan, and may
				require that specified documentation be submitted to the LCA by the agency or
				may include the use of on-site surveys by the LCA to ascertain compliance in
				specified areas.
CI. MONITORING
				PLAN means a written set of guidelines and instructions specified by the LCA
				for a program to follow for the purpose of correcting deficiencies.
CJ. MORAL TURPITUDE means conduct contrary to
				justice, honesty, modesty or good morals, as further specified in 8.8.3
				NMAC.
CK. MULTI SYSTEMIC THERAPY
				(MST) is an intensive family and community-based treatment program that
				addresses the known determinants of serious antisocial behavior in adolescents
				and their families. MST treats the factors in the youth's environment that are
				contributing to his or her behavior problems. Such factors might pertain to
				individual characteristics of the youth (poor problem solving skills), family
				relations (inept discipline), peer relations (association with deviant peers)
				and school performance. Treatment goals for therapeutic change are developed on
				an individualized basis in collaboration with the family.
CL. NEGLECT by individuals or an agency
				means:
(1) failure to provide any treatment,
				service, care, medication or item that is reasonably necessary to maintain the
				health or safety of a client; or
(2) failure to take any reasonable precaution
				that is necessary to prevent damage to the health or safety of a client;
				or
(3) failure to carry out a duty
				to supervise properly or control the provision of any treatment, care, good
				service or medication reasonably necessary to maintain the health or safety of
				a client; or
(4) failure to take
				any reasonable precaution that would prevent the physical abuse, sexual abuse,
				or sexual exploitation of a client, as defined in the Children's Code at 1978
				NMSA 32A-4-2, or the lack of which causes the client to become an abused child
				or neglected child as defined in the Children's Code at NMSA 1978
				32A-4-2.