Virginia Administrative Code › Title 12 - HEALTH › Agency 30 - DEPARTMENT OF MEDICAL ASSISTANCE SERVICES › Chapter 60 - STANDARDS ESTABLISHED AND METHODS USED TO ASSURE HIGH QUALITY CARE › Section 12VAC30-60-61 - Services related to the Early and Periodic Screening, Diagnosis and Treatment Program (EPSDT); community mental health and behavioral therapy services for youth

Current through Register Vol. 40, No. 24, July 15, 2024
A. Definitions.
				The following words and terms when used in this section shall have the
				following meanings unless the context indicates otherwise:
"At risk" means one or more of the following:
(i) within the two weeks before the,
				comprehensive needs assessment, the individual shall be screened by a licensed
				mental health professional (LMHP), licensed mental health professional-resident
				(LMHP-R), licensed mental health professional--resident in psychology LMHP-RP,
				or licensed mental health professional-supervisee (LMHP-S) for escalating
				behaviors that have put either the individual or others at immediate risk of
				physical injury;
(ii) the parent or
				guardian is unable to manage the individual's mental, behavioral, or emotional
				problems in the home and is actively, within the past two to four weeks,
				seeking an out-of-home placement;
(iii) a representative of either a juvenile
				justice agency, a department of social services (either the state agency or
				local agency), a community services board/behavioral health authority, the
				Department of Education, or an LMHP, LMHP-R, LMHP-RP, or LMHP-S, and who is
				neither an employee of nor consultant to the intensive in-home (IIH) services
				or therapeutic day treatment (TDT) provider, has recommended an out-of-home
				placement absent an immediate change of behaviors and when unsuccessful mental
				health services are evident;
(iv)
				the individual has a history of unsuccessful services (either crisis
				intervention, crisis stabilization, outpatient psychotherapy, outpatient
				substance abuse services, or mental health skill-building) within the past 30
				calendar days; or
(v) the treatment
				team or family assessment planning team (FAPT) recommends IIH services or TDT
				for an individual currently who is either:
(a) transitioning out of psychiatric
				residential treatment facility (PRTF) services,
(b) transitioning out of a therapeutic group
				home,
(c) transitioning out of acute
				psychiatric hospitalization, or
(d)
				transitioning between foster homes, mental health case management, crisis
				intervention, crisis stabilization, outpatient psychotherapy, or outpatient
				substance abuse services.
"Comprehensive needs assessment" means the same as defined in
				  12VAC30-50-130.
"Licensed assistant behavior analyst" means a person who has
				  met the licensing requirements of 18VAC85-150 and holds a valid license issued
				  by the Department of Health Professions.
"Licensed behavior analyst" means a person who has met the
				  licensing requirements of 18VAC85-150 and holds a valid license issued by the
				  Department of Health Professions.
"Out-of-home placement" means placement in one or more of
				  the following:
(i) therapeutic group
				home;
(ii) regular foster home if
				the individual is currently residing with the individual's biological family
				and, due to his behavior problems, is at risk of being placed in the custody of
				the local department of social services;
(iii) treatment foster care if the individual
				is currently residing with the individual's biological family or a regular
				foster care family and, due to the individual's behavioral problems, is at risk
				of removal to a higher level of care;
(iv) psychiatric residential treatment
				facility;
(v) emergency shelter for
				the individual only due either to his mental health or behavior or both;
(vi) psychiatric hospitalization;
				or
(vii) juvenile justice system or
				incarceration.
"Progress notes" means individual-specific documentation that
				  contains the unique differences particular to the individual's circumstances,
				  treatment, and progress that is also signed and contemporaneously dated by the
				  provider's professional staff who have prepared the notes. Individualized
				  progress notes are part of the minimum documentation requirements and shall
				  convey the individual's status, staff interventions, and, as appropriate, the
				  individual's progress or lack of progress toward goals and objectives in the
				  plan of care.
"Qualified paraprofessional in mental health" or "QPPMH"
				  means the same as the term is defined in
				  12VAC35-105-20.
"Unsuccessful services" means, as measured by ongoing
				  behavioral, mental, or physical distress, that the services did not treat or
				  resolve the individual's mental health or behavioral issues.
"Youth" means an individual younger than 21 years of age who
				  is receiving community mental health or behavioral therapy services.