Cal. Code Regs. Tit. 22, § 51341 - Short-Doyle Mental Health Medi-Cal Program Services
(a) Community mental health services, as
defined in this section, provided by Short-Doyle Medi-Cal providers to Medi-Cal
beneficiaries are covered by the Medi-Cal program.
(b) Community Mental Health Services.
(1) Acute inpatient hospital service means
those services provided by a hospital, including bed and board, to a Medi-Cal
beneficiary who needs intense diagnosis and/or treatment of an acute
psychiatric condition on a continuous 24-hour a day basis.
(2) Psychiatric health facility services
means therapeutic and/or rehabilitation services provided in a non-hospital 24
hour inpatient setting, on either a voluntary or involuntary basis. Services
are provided to individuals experiencing an acute psychiatric episode or
crisis, whose physical health needs can be met in an affiliated hospital or in
outpatient settings.
(3) Mental
health service means interventions designed to provide the maximum reduction of
mental disability and restoration or maintenance of functioning consistent with
the requirements for learning, development, independent living and enhanced
self-sufficiency. Services shall be directed toward achieving the individual's
goals/desired results/personal milestones.
(4) Medication support service means
prescribing, administering, dispensing and monitoring of psychiatric
medications necessary to alleviate the symptoms of mental illness which are
provided by a staff person within the scope of practice of his/her
profession.
(5) Day treatment
intensive service means services provided by an organized and structured
multi-disciplinary treatment program as an alternative to hospitalization, to
avoid placement in a more restrictive setting, or to maintain the individual in
a community setting. These services are provided to a distinct group of
individuals and occur in a therapeutic, organized and structured setting. Day
treatment intensive is a packaged program with service available at least three
hours and less than 24 hours each day the program is open.
(6) Day rehabilitation service means
evaluation, rehabilitation and therapy to maintain or restore personal
independence and functioning consistent with requirements for learning and
development. It is an organized and structured program which provides services
to a distinct group of individuals. Day rehabilitation is a packaged program
with service available at least three hours and less than 24 hours each day the
program is open.
(7) Adult
residential treatment service means rehabilitation services provided in a
non-institutional residential setting where individuals are supported in their
efforts to restore, maintain and apply interpersonal and independent living
skills, and access community support systems. Programs shall provide a
therapeutic community including a range of activities and services for
individuals who would be at risk of hospitalization or other institutional
placement if they were not in the residential treatment program. This is a
structured package program with services available day and night, seven days a
week.
(8) Crisis residential
treatment services means therapeutic and/or rehabilitation services provided in
a 24-hour residential treatment program for individuals experiencing an acute
psychiatric episode or crisis, and who do not present medical complications
requiring nursing care. Individuals are supported in their efforts to restore,
maintain and apply interpersonal and independent living skills, and access
community support systems. Interventions which focus on symptom reduction shall
also be available. This is a structured, packaged program with services
available day and night, seven days a week.
(9) Crisis intervention means quick emergency
response service enabling the individual to cope with a crisis, while
maintaining his/her status as a functioning community member to the greatest
extent possible. A crisis is an unplanned event that results in the
individual's need for immediate service intervention. Crisis intervention
services are limited to stabilization of the presenting emergency.
(10) Crisis Stabilization -- Emergency Room
means an immediate face-to-face response lasting less than 24 hours, to or on
behalf of an individual exhibiting acute psychiatric symptoms, provided in a
24-hour health facility or hospital based outpatient program. The goal is to
avoid the need for inpatient services by alleviating problems which, if not
treated, present an imminent threat to the individual or other's safety or
substantially increase the risk of the individual becoming gravely
disabled.
(11) Crisis Stabilization
-- Urgent Care means an immediate face-to-face response lasting less than 24
hours, to or on behalf of an individual exhibiting acute psychiatric symptoms,
provided at a certified Mental Health Rehabilitation provider site. The goal is
to avoid the need for inpatient services by alleviating problems and symptoms
which, if not treated, present an imminent threat to the individual or other's
safety or substantially increase the risk of the individual becoming gravely
disabled. Services provided to individuals in a Crisis stabilization -- Urgent
Care program are not based in 24-hour health care facilities or hospital based
outpatient programs. Services shall be available 24 hours per day.
(12) Case management brokerage means
activities provided by program staff to access medical, educational, social,
prevocational, vocational, rehabilitative, or other needed community services
for eligible individuals.
Notes
2. Order of Repeal of 6-29-84 emergency language filed 11-26-84 by OAL pursuant to Government Code Section 11349.6(b) (Register 84, No. 48).
3. Amendment filed 1-31-85 as an emergency; designated effective 2-1-85 (Register 85, No. 7). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 6-3-85.
4. Certificate of Compliance transmitted to OAL 5-17-85 and filed 6-14-85 (Register 85, No. 24).
5. New subsections (b)(10) and (c)(3)-(4) and amendment of NOTE filed 10-5-93 as an emergency; operative 10-5-93 (Register 93, No. 41). A Certificate of Compliance must be transmitted to OAL by 2-2-94 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 10-5-93 order transmitted to OAL 2-2-94 and filed 3-15-94 (Register 94, No. 11).
7. Repealer and new subsections (b)(2)-(10) and new subsections (b)(11)-(12) filed 10-2-95 as an emergency; operative 10-2-95 (Register 95, No. 40). A Certificate of Compliance must be transmitted to OAL by 1-30-96 or emergency language will be repealed by operation of law on the following day.
8. Amendment of section heading, subsection (a) and repealer of subsections (c)-(c)(4) filed 12-14-95 as an emergency; operative 12-14-95 (Register 95, No. 50). A Certificate of Compliance must be transmitted to OAL by 4-12-96 or emergency language will be repealed by operation of law on the following day.
9. Certificate of Compliance as to 10-2-95 order including amendment of subsection (b)(4) transmitted to OAL 1-26-96 and filed 3-7-96 (Register 96, No. 10).
10. Reinstatement of subsections as they existed prior to emergency amendment filed 12-14-95 by operation of Government Code section 11346.1 (Register 96, No. 16).
11. Amendment of section heading, subsection (a) and repealer of subsections (c)-(c)(4) filed 4-16-96 as an emergency; operative 4-16-96 (Register 96, No. 16). A Certificate of Compliance must be transmitted to OAL by 8-14-96 or emergency language will be repealed by operation of law on the following day.
12. Certificate of Compliance as to 4-16-96 order transmitted to OAL 8-13-96 and filed 9-25-96 (Register 96, No. 39).
Note: Authority cited: Sections 10725, 14021.3, 14021.5 and 14124.5, Welfare and Institutions Code. Reference: Sections 14021, 14021.3 and 14021.5, Welfare and Institutions Code.
2. Order of Repeal of 6-29-84 emergency language filed 11-26-84 by OAL pursuant to Government Code Section 11349.6(b) (Register 84, No. 48).
3. Amendment filed 1-31-85 as an emergency; designated effective 2-1-85 (Register 85, No. 7). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 6-3-85.
4. Certificate of Compliance transmitted to OAL 5-17-85 and filed 6-14-85 (Register 85, No. 24).
5. New subsections (b)(10) and (c)(3)-(4) and amendment of Note filed 10-5-93 as an emergency; operative 10-5-93 (Register 93, No. 41). A Certificate of Compliance must be transmitted to OAL by 2-2-94 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 10-5-93 order transmitted to OAL 2-2-94 and filed 3-15-94 (Register 94, No. 11).
7. Repealer and new subsections (b)(2)-(10) and new subsections (b)(11)-(12) filed 10-2-95 as an emergency; operative 10-2-95 (Register 95, No. 40). A Certificate of Compliance must be transmitted to OAL by 1-30-96 or emergency language will be repealed by operation of law on the following day.
8. Amendment of section heading, subsection (a) and repealer of subsections (c)-(c)(4) filed 12-14-95 as an emergency; operative 12-14-95 (Register 95, No. 50). A Certificate of Compliance must be transmitted to OAL by 4-12-96 or emergency language will be repealed by operation of law on the following day.
9. Certificate of Compliance as to 10-2-95 order including amendment of subsection (b)(4) transmitted to OAL 1-26-96 and filed 3-7-96 (Register 96, No. 10).
10. Reinstatement of subsections as they existed prior to emergency amendment filed 12-14-95 by operation of Government Code section 11346.1 (Register 96, No. 16).
11. Amendment of section heading, subsection (a) and repealer of subsections (c)-(c)(4) filed 4-16-96 as an emergency; operative 4-16-96 (Register 96, No. 16). A Certificate of Compliance must be transmitted to OAL by 8-14-96 or emergency language will be repealed by operation of law on the following day.
12. Certificate of Compliance as to 4-16-96 order transmitted to OAL 8-13-96 and filed 9-25-96 (Register 96, No. 39).
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