Division of Behavioral Health Services
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BHS Definitions List (revised 07/14/14)
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Recertification of Need (RON)
A certification by a physician, physician assistant or nurse practitioner that inpatient services continue to be needed for a person.
Recertification of Need (RON) (42 CFR 441.152, 456.30, 456.160) QM 2.9/QM 3.0
A RON is a re-certification made by a physician, nurse practitioner or physician assistant that inpatient services are still needed for a person. A RON must be completed at least every 60 days for a person who is receiving services in a Level I facility. An exception to the 60-day timeframe exists for inpatient services provided to persons under the age of 21. The treatment plan (individual plan of care) and RON for persons under the age of 21 in a Level I facility must be completed and reviewed every 30 days.
Recovery is a deeply personal process and no single, universally accepted definition of recovery currently exists. In the simplest sense, recovery is a lived experience of moving through and beyond the limits of one's disorder; living a life outside of one's illness. In this process one finds hope, empowerment, self-responsibility and a meaningful role in life. Key characteristics of recovery include:
- Recovery is personal and individualized (not defined by a treatment agency)
- Recovery moves beyond symptom reduction and relief (e.g. meaningful connections in the community, overcoming specific skill deficits, establishing a sense of quality and well-being)
- Recovery is both a process of healing (regaining) and a process of discovery (moving beyond)
- Recovery encompasses the possibility for individuals to test, make mistakes, and try again.
Recovery can occur within or outside the context of professionally directed treatment.
Describes where the person wants to be and how they will know when a service is no longer needed. Provides a vision of how the person would like their life, family and environment.
Reduction of Service
Reduction of service occurs when a decision is made to reduce the frequency or duration of an ongoing service. A reduction of service does not include a planned change in service frequency or duration that is initially identified in the person's service plan and agreed to in writing by the person receiving services or his/her legal guardian.
Required activities by providers designed to encourage the consumer to remain enrolled and continue receiving services.
Referral for Behavioral Health Services
Any oral, written, faxed, or electronic request for behavioral health services made by any person, or person's legal guardian, family member, an AHCCCS health plan, primary care provider, hospital, jail, court, probation and parole officer, tribal government, Indian Health Services, school, or other governmental or community agency.
Geographical region designated by ADHS in its contract with the Regional Behavioral Health Authority.
Regional Behavioral Health Authority (RBHA)
An organization under contract with ADHS that administers covered behavioral health services in a geographically specific area of the state.
A governmental organization that ensures laws and regulations in a particular industry are enforced (e.g., Child Protective Services, Adult Protective Services, Attorney General's Office, Medical Board, Board of Nursing, Board of Behavioral Health Examiners, Office of Behavioral Health Licensing, AHCCCS).
An electronic or paper document submitted to a provider to explain the disposition of a claim.
For purposes of this policy means living in a particular locality, in this case the State of Arizona, on permanent basis.
Evaluation of a vulnerable individual who may currently be placed in a nursing facility or may be in need of nursing facility placement, to ensure appropriateness of nursing facility placement and provision of adequate behavioral health services.
Behavioral health services provided in a facility licensed pursuant to Arizona Administrative Code, Title 9, Chapter 20, as a level II or level III facility.
Residential Treatment Center (RTC)
A facility that provides Level I services licensed per 9 A.A.C. 20 to provide services to persons under the age of 21.
The personal and community qualities that enable us to rebound from adversity, trauma, tragedy, threats, and other stresses and to go on with life with a sense of mastery, competence, and hope (New Freedom Commission on Mental Health, 2003).
Means personal restraint, mechanical restraint or drug used as a restraint and is the following in accordance with 42 CFR 482.13(e)(1):
- Any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a behavioral health recipient to move his or her arms, legs, body, or head freely; or
- A drug or medication when it is used as a restriction to manage the behavioral health recipient's behavior or restrict the behavioral health recipient's freedom of movement and is not a standard treatment or dosage for the behavioral health recipient's condition.
- A restraint does not include devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or other methods that involve the physical holding of a behavioral health recipient for the purpose of conducting routine physical examinations or tests, or to protect the behavioral health recipient from falling out of bed, or to permit the behavioral health recipient to participate in activities without the risk of physical harm (this does not include a physical escort).
A claim where no eligibility was entered in the AHCCCSA system for the date(s) of service but at a later date, eligibility was posted retroactively to cover the date(s) of service.
Conditions that increase the risk of a particular problem from developing.
A response that is within timeframes indicated by the person's clinical needs, but does not require an immediate or urgent response.