Access to Care Standards - Minimum eligibility requirements for Medicaid eligible persons to access mental health services through the publicly funded system.

Acute: Situation in which a child or adolescent is in need of immediate mental health services due to the acuity of their mental illness.

At Risk Youth/Becca Bill: Laws of 1995 Chapter 313 amended RCW 71.34 and other statues covering child welfare, chemical dependency, and truancy. The bill's purpose was to preserve, strengthen and reconcile families experiencing problems with at-risk youth. The bill included court interventions and treatment for at-risk and truant youth.

Brief Intervention: Solution focused, outcomes oriented and time limited set of activities for the purpose of achieving goals identified in the consumer's individual treatment plan.

Child Psychiatrist: A person having a license as a physician and surgeon in this state, who has had graduate training in child psychiatry in a program approved by the American Medical Association or the American Osteopathic Association, and who is board eligible or board certified in child psychiatry.

Children's Mental Health Specialist:
(a) A mental health professional who has completed a minimum of one hundred actual hours, not quarter or semester hours, of specialized training devoted to the study of child development and the treatment of children; and
(b) A mental health professional who has the equivalent of one year of full-time experience in treating children under the supervision of a children's mental health specialist.

Children's Long-Term Inpatient Programs (CLIP): Long-term residential inpatient program for children and youths. There are five CLIP programs, including CSTC. The CLIP Administration is the clinical and administrative authority overseeing admissions to the CLIP programs.

Child Study and Treatment Center (CSTC): The state psychiatric hospital for children and youths and one of the CLIP Programs.

Commitment : A determination by a judge or court commissioner, made after an involuntary commitment hearing, that the minor is in need of inpatient diagnosis, evaluation, or treatment or that the minor is in need of less restrictive alternative treatment, and the minor is unwilling to consent to such care voluntarily.

Community Mental Health Agency (CMHA) - A licensed facility providing mental health services. Throughout this page, community mental health agencies will be called agencies.

Consent : Agreement to receive treatment following the act of informing the patient about the nature and character of proposed treatment, anticipated results of treatment and alternative forms of treatment.

County Designated Mental Health Professional (CDMHP): A mental health professional designated by one or more counties to perform the functions of a county-designated mental health professional described in RCW 71.34.

Crisis Triage : The continuum of activities and services that provide a coordinated, integrated and multi-disciplinary approach to the assessment and stabilization of persons who are experiencing behavioral health crisis and the linkage of these persons to other needed supportive services.

Emergent Care - Service provided for a person that, if not provided, would likely result in the need for crisis intervention or for hospital evaluation due to concerns of potential danger to self, others, or grave disability.

Enrollee - A Medicaid recipient who is enrolled in a pre-paid inpatient health plan.

Evaluation and Treatment Facility: A public or private facility or unit that is certified by the department to provide emergency, inpatient, residential, or outpatient mental health evaluation and treatment services for minors. A physically separate and separately operated portion of a state hospital may be designated as an evaluation and treatment facility for minors. A facility which is part of or operated by the department or federal agency does not require certification. No correctional institution or facility, juvenile court detention facility, or jail may be an evaluation and treatment facility within the meaning of RCW 71.34.

Evaluation and Treatment Program: The total system of services and facilities coordinated and approved by a county or combination of counties for the evaluation and treatment of minors under RCW 71.34. There are very few certified Inpatient Evaluation and Treatment facilities for children and youths.

Family Support: Family support groups and advocacy to families in which there is a seriously disturbed child or adolescent or an adult with severe and persistent mental illness.

Gravely Disabled Minor: A minor who, as a result of a mental disorder, is in danger of serious physical harm resulting from a failure to provide for his or her essential human needs of health or safety, or manifests severe deterioration in routine functioning evidenced by repeated and escalating loss of cognitive or volitional control over his or her actions and is not receiving such care as is essential for his or her health or safety.

Group Treatment: Set of face-to-face activities provided by one or more staff under the supervision of a mental health professional to two or more consumers which are designed to help a consumer attain goals as described in the consumer's individual treatment plan.

Individual Treatment: A set of treatment activities designed to help a consumer attain goals as prescribed in the consumer's individual treatment plan.

Individualized and Tailored Care (ITC): A process utilized in individualized, strengths-based treatment. The process is also known as Wraparound.

Inpatient Treatment: Twenty-four-hour-per-day mental health care provided within a general hospital, psychiatric hospital, or residential treatment facility certified by the department as an inpatient evaluation and treatment facility for minors.

Least Restrictive Alternative (LRA) or Less Restrictive Setting : Outpatient treatment provided to a minor who is not residing in a facility providing inpatient treatment as defined in RCW 71.34.

Level of Functioning: Determined by assessments that look at the child or adolescent's level of performance across life areas such as psychological, social, educational, daily living skills etc. Level of functioning is used in treatment planning and assessing change over time.

Likelihood of Serious Harm: Either: (a) A substantial risk that physical harm will be inflicted by an individual upon his or her own person, as evidenced by threats or attempts to commit suicide or inflict physical harm on oneself; (b) a substantial risk that physical harm will be inflicted by an individual upon another, as evidenced by behavior which has caused such harm or which places another person or persons in reasonable fear of sustaining such harm; or (c) a substantial risk that physical harm will be inflicted by an individual upon the property of others, as evidenced by behavior which has caused substantial loss or damage to the property of others.

Medical Necessity or Medically Necessary - A requested service which is reasonably calculated to prevent, diagnose, correct, cure, alleviate or prevent the worsening of conditions in the recipient that endanger life, or cause suffering or pain, or result in illness or infirmity, or threaten to cause or aggravate a handicap, or cause or physical deformity or malfunction, and there is no other equally effective, more conservative or substantially less costly course of treatment available or suitable for the person requesting service. Course of treatment may include mere observation or, where appropriate, no treatment at all.

Additionally, the individual must be determined to have a mental illness covered by Washington State for public mental health services. The individual's impairment(s) and corresponding need(s) must be the result of a mental illness. The intervention is deemed to be reasonably necessary to improve, stabilize or prevent deterioration of functioning resulting from the presence of a mental illness. The individual is expected to benefit from the intervention. Any other formal or informal system or support can not address the individual's unmet need.

Medication Management: The prescribing and/or administering and reviewing of medications and their side effects.

Medication Monitoring: Cueing, observing, and encouraging consumers to ensure that medications are taken as prescribed and reporting back to persons licensed to perform medication management services for the benefit of the consumer.

Mental Disorder: Any organic, mental, or emotional impairment that has substantial adverse effects on an individual's cognitive or volitional functions. The presence of alcohol abuse, drug abuse, juvenile criminal history, antisocial behavior, or mental retardation alone is insufficient to justify a finding of "mental disorder" within the meaning of this section.

Mental Health Care Provider (MHCP) - The individual with primary responsibility for implementing an individualized plan for mental health rehabilitation services.

Mental Health Professional - An individual who meets the standards defined in Washington State law. The standards are based on how much education the person has and how much experience the person has in mental health. Most mental health professionals have a Master's Degree and at least two years experience in mental health. There are some exceptions which are defined in the law. Psychiatrists, psychologists, psychiatric nurses and social workers are all mental health professionals.

Minor : Any person under the age of eighteen years. Under RCW 71.34, a minor is a person 13 years of age up to his or her 18th birthday.

Ombuds Service - A person who can help you when you need to file a grievance or fair hearing.

Outpatient Service - Mental health services provided in the community.

Parent :
a. A biological or adoptive parent who has legal custody of the child, including either parent if custody is shared under a joint custody agreement; or
b. A person or agency judicially appointed as legal guardian or custodian of the child.

Parent Support : A type of support parents or caregivers who are raising or have raised children with complex mental health needs provides to another. The support is based on the personal experiences of the supporting parent.

Psychoeducation : A core set of characteristics of effective psychoeducation programs that teach and explore the provision of emotional support, education, reducing stressors, resources during periods of crisis, and problem-solving skills to consumers and their family members.

Professional Person in Charge or Professional Person : A physician or other mental health professional empowered by an evaluation and treatment facility with authority to make admission and discharge decisions on behalf of that facility.

Psychiatric Nurse : A registered nurse who has a bachelor's degree from an accredited college or university, and who has had, in addition, at least two years' experience in the direct treatment of mentally ill or emotionally disturbed persons, such experience gained under the supervision of a mental health professional. "Psychiatric nurse" shall also mean any other registered nurse who has three years of such experience.

Psychiatrist : A person having a license as a physician in this state who has completed residency training in psychiatry in a program approved by the American Medical Association or the American Osteopathic Association, and is board eligible or board certified in psychiatry.

Psychologist : A person licensed by a state examining board. This person must pass an oral or written exam or both as prescribed by the examining board. In addition, this person must have a doctoral degree from a regionally accredited institution obtained from an integrated program of graduate study in psychology. This person must also have had at least two years of supervised experience of which at least was one must have been after the doctoral degree was granted. RCW 18.83.070

Recovery - Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.

Responsible Other : The minor, the minor's parent or estate, or any other person legally responsible for support of the minor.

Start of Initial Detention : The time of arrival of the minor at the first evaluation and treatment facility offering inpatient treatment if the minor is being involuntarily detained at the time. With regard to voluntary patients, "start of initial detention" means the time at which the minor gives notice of intent to leave under the provisions of this chapter.

Urgent Care - To be provided to persons approaching a mental health crisis. If services are not received within 24 hours of the request, the person's situation is likely to deteriorate to the point that emergent care is necessary.

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