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Division of Behavioral Health Services
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BHS Definitions List (revised 02/25/14)
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The portion of a capitation or allocation funding payment that is held back (permanent) from the RBHA by ADHS/DBHS because the RBHA failed to submit a sufficient amount (see Table 2) of CIS "clean" encounters. This should be recorded by the RBHA as an administrative expense.
Schizophrenic Spectrum Disorder
For the purpose of PM Section 3.16, Medication Formularies, Schizophrenic Spectrum Disorder includes Schizophreniform Disorder, Schizophrenia, and Schizoaffective Disorder in addition to the subtypes of Schizophrenia. DSM-IV-TR Cluster A personality disorders and other psychotic disorders are excluded from this definition.
The involuntary confinement of a behavioral health recipient in a room or an area from which the person cannot leave.
Seclusion – Individuals Determined to have a Serious Mental Illness
The restriction of a behavioral health recipient to a room or area through the use of locked doors or any other device or method which precludes a person from freely exiting the room or area or which a person reasonably believes precludes his/her unrestricted exit. In the case of an inpatient facility, confining a behavioral health recipient to the facility, the grounds of the facility, or a ward of the facility does not constitute seclusion. In the case of a community residence, restricting a behavioral health recipient to the residential site, according to specific provisions of an individual service plan or court order, does not constitute seclusion.
Seclusion- Level I Programs
(42 CFR 482.13(1)(ii)) The involuntary confinement of a person in a room or an area where the person is physically prevented from leaving.
Seclusion, Sub-Acute Agency
(A.A.C. R9-21-101) The involuntary confinement of a behavioral health recipient in a room or an area from which the behavioral health recipient cannot leave, but does not include the confinement of a behavioral health recipient in a correctional facility.
Section 8 is the more common name for the Housing Choice Voucher Program which is sponsored by the Department of Housing and Urban Development (HUD). Qualified applicants receive vouchers which are used to subsidize the cost of housing. These vouchers are awarded to individuals who meet certain income and earned income requirements. The goal of these programs is to provide affordable low cost housing to low income occupants.
Serious Emotional Disturbance (SED)
- Children from birth up to age 18; AND
- Child currently or at any time during the past year, has had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified in the Diagnostic and Statistical Manual, Fourth Edition, Text Revision (DSM-IV-TR). Qualifying SED diagnoses are listed as ICD-9 codes in ADHS/DBHS Provider Manual Attachment 7.5.3, SMI and SED Qualifying Diagnoses Table;
The mental, behavioral or emotional disorder has resulted in functional impairment which substantially interferes with or limits the child's role or functioning in family, school, or community activities. Such roles or functioning include achieving or maintaining developmentally appropriate social, behavioral, cognitive, communicative, or adaptive skills. Functional impairments of episodic, recurrent, and continuous duration are included unless they are temporary and expected responses to stressful events in the environment.
Any significant impairment of the physical condition of the person as determined by qualified medical personnel. This includes, but is not limited to, burns, lacerations, bone fractures, substantial hematoma and injuries to internal organs, whether self-inflicted or inflicted by someone else.
Serious Mental Illness (SMI)
A condition of persons who are eighteen years of age or older and who, as a result of a mental disorder as defined in A.R.S. 36-501, exhibit emotional or behavioral functioning which is so impaired as to interfere substantially with their capacity to remain in the community without supportive treatment or services of a long -term or indefinite duration. In these persons mental disability is severe and persistent, resulting in a long-term limitation of their functional capacities for primary activities of daily living such as interpersonal relationships, homemaking, self-care, employment and recreation.
Serious Mental Illness MI 5.3
For purposes of this policy, an individual is considered to have a serious mental illness if the individual meets the requirement for a serious mental illness diagnosis, which is identified by using Provider Manual Attachment 3.10.1, Serious Mental Illness (SMI) Qualifying Diagnosis to establish a qualifying diagnosis for this program. This is not the same as the "Serious Mental Illness Determination" process according to the Department of Health Services, Behavioral Health Services for Persons with Serious Mental Illness (A.A.C. R9-21) Rules. For a person to be covered under the PASRR program, a "Serious Mental Illness Determination" is not required.
(A.A.C. R9-20-601 and R9-20-202) Any of the following that occurred on the premises or during a licensee sponsored activity off the premises that required medical services or immediate intervention by an emergency response team or a medical practitioner:
- A serious injury, or any significant impairment of the physical condition of the behavioral health recipient as determined by qualified medical personnel. This includes, but is not limited to, burns, lacerations, bone fractures, substantial hematoma, and injuries to internal organs, whether self-inflicted or inflicted by someone else;
- A medication error or an adverse reaction to a medication;
- Suspected or alleged abuse, neglect, or exploitation of the behavioral health recipient or a violation of the behavioral health recipient's rights under R9-20-203(B) or (C);
- Food poisoning possibly resulting from food provided at the agency or during a licensee-sponsored activity off the premises;
- An unauthorized absence from a residential agency or an inpatient treatment program;
- A physical injury that occurred as the result of a personal or mechanical restraint;
- A behavioral health recipient's death; or
- A behavioral health recipient's suicide attempt.
Serious Occurrence Section 7.4
A behavioral health recipient's death, a serious injury to a behavioral health recipient or a suicide attempt by a behavioral health recipient.
Serious physical injury
Physical injury that creates a reasonable risk of death or that causes serious or permanent disfigurement, serious impairment of health or loss or protracted impairment of the function of any bodily organ or limb.
Service Authorization Request
A behavioral health recipient's request, through a behavioral health provider, for the provision of a covered service that requires prior authorization.
A written description of the covered behavioral health services and other informal supports that have been identified through the assessment process that will assist the person to meet his/her specified goals.
Sexual misconduct caused by acts or omissions of an employee or contracted staff of the Arizona State Hospital or the T/RBHA or subcontracted provider. Sexual abuse includes molestation, sexual assault, incest, or prostitution of, or with, a person receiving services.
Shelter Plus Care
The Shelter Plus Care program (S+C) is authorized by title IV, subtitle F, of the Stewart B. McKinney Homeless Assistance Act (the McKinney Act) (42 U.S.C. 11403– 11407b). S+C is designed to link rental assistance to supportive services for hard-to-serve homeless persons with disabilities (primarily those who are seriously mentally ill; have chronic problems with alcohol, drugs, or both; or have acquired immunodeficiency syndrome (AIDS) and related diseases) and their families. The program provides grants to be used for rental assistance for permanent housing for homeless persons with disabilities. Rental assistance grants must be matched in the aggregate by supportive services that are equal in value to the amount of rental assistance and appropriate to the needs of the population to be served.
Single Case Agreement
If the services to meet an identified clinical need are not available within the contracted network, necessary services are provided in a timely manner through an out-of-network provider. A single case agreement is a contractual agreement developed for an enrolled person based on that person's behavioral health needs and for a predetermined period of time.
Systematic approaches to gathering information that rely on established processes and procedures drawn from scientific research techniques.
The support provided to a person determined to have a Serious Mental Illness who is unable to articulate treatment preferences and/or participate effectively in the development of the Individual Service Plan (ISP), Inpatient Treatment and Discharge Plan (ITDP), grievance and/or appeal processes due to cognitive or intellectual impairment and/or medical condition.
Assistance provided to a person who has been determined to need additional assistance to fully understand and participate in the Service Plan (SP) or the Inpatient Treatment and Discharge Plan (ITDP) process, the appeal process, or the grievance or request for investigation process.
Populations of people that may include, but not limited to individuals that are underrepresented/underserved and fall into population groups that are made vulnerable, at risk or hard to reach because of:
- economic disadvantage,
- limited language competence,
- cultural/geographical isolation,
- age group
- physical, mental, cognitive or sensory disability
Specialized Services (pertaining to a Serious Mental Illness)
Specialized services are those services specified by the Arizona Department of Health Services, Division of Behavioral Health Services (ADHS/DBHS) that, when combined with services provided by the NF, result in continuous and aggressive implementation of an individualized plan of care. The plan of care:
- Is developed and supervised by an interdisciplinary team which includes a physician, qualified mental health professionals, and, as appropriate, other professionals;
- Prescribes specific therapies and activities for the treatment of persons experiencing an acute episode of Serious Mental Illness which requires intervention by trained behavioral health personnel, and
- Is directed toward:
- Diagnosing and reducing the person's behavioral symptoms that necessitate institutionalization;
- Improving his/her level of independent functioning; and
- Achieving a functioning level that permits reduction in the intensity of mental health services to below the level of specialized services at the earliest possible time.
Sponsor-based Rental Assistance
Sponsor-based rental assistance provides a subsidy for rental assistance through contracts between the grantee and contracted sponsor organization. A sponsor may be a private nonprofit organization or a community mental health agency established as a public nonprofit organization. Participants reside in housing owned or leased by the sponsor.
State Placing Agencies
This term refers to the department of juvenile corrections, the department of economic security, the department of health services or the administrative office of the court. (A,R.S. § 15-1181(12) )
Results of a study are not likely to have occurred by chance alone. By convention, a difference between two groups is usually considered statistically significant if chance could explain it only 5% of the time or less.
A cluster of negative attitudes and beliefs that motivate the general public to fear, reject, avoid, and discriminate against people with mental illnesses. Stigma leads to low self-esteem, isolation, and hopelessness in individuals, and deters the public from seeking and wanting to pay for care. Responding to stigma, people with mental health problems often internalize public attitudes and become so embarrassed or ashamed that they conceal symptoms and fail to seek treatment.
A tool used to measure or gauge, over time, the performance of functions or goals of an individual, organization or service.
A facility that provides inpatient services licensed per 9 A.A.C. 20.
A Community Service Agency that has been Title XIX Certified by the Department, has registered with AHCCCS, and holds a contract with a RBHA or Tribal RBHA or designee.
The continued use of alcohol or other drugs in spite of negative consequences.
The ingestion of alcohol or other drugs without the experience of any negative consequences.
Support and Rehabilitation Services
Support and Rehabilitation Services are two categories of Medicaid covered services that behavioral health providers in Arizona may provide to enrolled children and their families. These services are sometimes known by other names, such as Direct Support Services, In-Home and Community-Based Support Services, Peer and Family-Delivered In-Home and Community–Based Support Services, or Wraparound Services. Because there are potential differences between each of these terms, this protocol uses the name Support and Rehabilitation Services.
Support and Rehabilitation Services Provider
A behavioral health provider agency that delivers Support and Rehabilitation Services as defined above. There are two main types of Support and Rehabilitation Services providers:
- Generalist Support and Rehabilitation Services Providers - configure their program operations to the needs of the Child and Family Team without arbitrary limits on frequency, duration, type of service, age, gender, population or other factors associated with the delivery of Support and Rehabilitation Services.
- Specialist Support and Rehabilitation Services Providers - provide either a limited scope of Support and Rehabilitation Services (such as primarily specializing in respite services or skills training services) and/or services that may be designed for a specific population, age, gender, frequency, duration or some other factor (such as a service specializing in working with teenagers or those with a history of displaying harmful sexual behaviors).
Supported Housing Services
Services, as defined in the ADHS/DBHS Covered Behavioral Health Services Guide (see service code H0043), that are provided to assist individuals or families to obtain and maintain housing in an independent community setting including the person's own home or apartments and homes that are owned or leased by a subcontracted provider. These services may include rent and utility subsidies, and relocation services to a person or family for the purpose of securing and maintaining housing.
Housing, as defined in 24 CFR Part 583, in conjunction with which supportive services are provided for tenants if the housing is safe and sanitary and meets any applicable State and local housing codes and licensing requirements in the jurisdiction in which the housing is located and the requirements of this part; and the housing is transitional housing; safe haven; permanent housing for homeless persons with disabilities; or is a part of, a particularly innovative project for, or alternative method of, meeting the immediate and long-term needs of homeless persons and families.
Suspension of Service
A decision to temporarily stop providing a service.