Definitions

The following terms used in 130 CMR 429.000 have the meanings given in 130 CMR 429.402 unless the context clearly requires a different meaning. Adverse Incident. An occurrence that represents actual or potential serious harm to the well- being of a member, or to others under the care of the mental health center. Adverse incidents may be the result of the actions of a member served, actions of a staff member providing services, or incidents that compromise the health, safety, or operations of the center. American Society of Addiction Medicine (ASAM). A professional society in the field of addiction medicine that sets diagnostic and dimensional criteria for the delivery of substance use disorder treatment which includes a continuum of five basic levels of care from Early Intervention to Medically Managed Intensive Inpatient Treatment. Behavioral Health Disorder. Any disorder pertaining to mental health or substance use as defined by the current edition of the Diagnostic and Statistical Manual of Mental Disorders. Behavioral Health Urgent Care (BHUC) Provider. A center that meets the requirements in 130 CMR 429.404(D). Case Consultation. Intervention, including scheduled audio-only telephonic, audio-video, or in- person meetings, for behavioral and medical management purposes on a member’s behalf with agencies, employers, or institutions which may include the preparation of reports of the member’s psychiatric status, history, treatment, or progress (other than for legal purposes) for other physicians, agencies, or insurance carriers. Care Coordination. The organization of a member’s care across multiple services and supports. Certified Peer Specialist (CPS). A person who has been trained by an agency approved by the Department of Mental Health (DMH) who is self-identified as having lived experience of a mental health disorder and wellness who can effectively share their experiences and serve as a mentor, advocate, or facilitator for a member experiencing a mental health disorder. Child and Adolescent Needs and Strengths (CANS). A standardized tool that organizes information gathered during behavioral health clinical assessments. A Massachusetts version of the tool has been developed and is intended to be used as a treatment decision support tool for behavioral health providers serving MassHealth members younger than 21 years of age. Communication Protocol. Formal descriptions of requirements that allow two or more providers to exchange information. Co-occurring Disorder. A diagnosis of both a substance use disorder and one or more behavioral health disorders. Core Discipline. Licensed behavioral health disciplines, including, but not limited to psychiatry, social work, psychology, or psychiatric nursing (including an advanced practice registered nurse), which compose a mental health center's multidisciplinary staff. Couples Therapy. Psychotherapeutic services provided to a couple whose primary issue is the disruption of their marriage, family, or relationship. Crisis Intervention. An urgent evaluation including assessment of risk, diagnosis, short-term intervention, and rendering of a disposition for a member’s presenting crisis, which may include referral to an existing or new behavioral health provider. Developmental Assessment. The assessment of developmental status including the administration of developmental testing to assess fine and/or gross motor, language, cognitive level, social, memory, and/or executive functions. Developmental Testing. The assessment of fine and/or gross motor, language, cognitive level, social, memory, and/or executive functions by standardized developmental instruments, which may include the interpretation and reporting of results. Diagnostic Evaluation Services. The examination and determination of a member’s physical, psychological, social, economic, educational, and vocational assets and disabilities for the purpose of designing a treatment plan. Direct and Continuous Supervision. Ongoing supervision provided to unlicensed staff and not independently licensed staff at a frequency of no fewer than one hour of supervision per week for full-time employees. Supervision time may be pro-rated based on scheduled hours for employees employed less than full-time. Direct and continuous supervision must be delivered by an independently licensed staff member or certified peer supervisor who is employed by the agency. Enhanced Structured Outpatient Addiction Program (E-SOAP). American Society of Addiction Medicine (ASAM) Level 2.1 Intensive Outpatient Services is a program that provides short-term, clinically intensive, structured day and/or evening substance use disorder services. E-SOAP specifically serves specialty populations including homeless members and people at risk of homelessness, pregnant members, and adolescents. E-SOAP services must meet requirements in 130 CMR 418.000: Substance Use Disorder Treatment Services. Family Consultation. A scheduled meeting with one or more of the parents, legal guardian, or foster parents of a child who is being treated by clinical staff at the center, when the parents, legal guardian, or foster parents are not clients of the center. Family Therapy. The psychotherapeutic treatment of more than one member of a family simultaneously in the same visit. Freestanding Clinic. Any institution licensed as a clinic by the Massachusetts Department of Public Health pursuant to M.G.L. c. 111, s. 51, that is not part of a hospital and that possesses its own legal identity, maintains its own patient records, and administers its own budget and personnel. Such institutions include mental health centers and community health centers. Group Therapy. The application of psychotherapeutic or counseling techniques to a group of members, most of whom are not related by blood, marriage, or legal guardianship. Individual Therapy. Psychotherapeutic services provided to a member. Intensive Outpatient Program (IOP). A mental health treatment service that provides time- limited, multidisciplinary, multimodal structured treatment in an outpatient setting for members requiring a clinical intensity that exceeds outpatient treatment. Service includes individual, group, and family therapy as well as case management services. Medication for Addiction Treatment (MAT). Use of a medication approved by the federal Food and Drug Administration (FDA) for the treatment of a substance use disorder. Medication for Opioid Use Disorder (MOUD). Use of a medication approved by the FDA for the treatment of opioid use disorder. Medication Visit. A member visit specifically for the prescription, review, and monitoring of medication by a psychiatrist, psychiatric clinical nurse specialist, advanced practice registered nurse, or physician assistant, or administration of prescribed intramuscular medication by a physician, nurse, or physician assistant. Mental Health Center (Center). An entity that delivers a comprehensive group of diagnostic and psychotherapeutic treatment services to members seeking treatment for mental health disorders, which may include co-occurring substance use disorder, and their families, by an interdisciplinary team under the medical direction of a psychiatrist. Mental Health Disorder. Any disorder pertaining to mental health as defined by the current edition of the Diagnostic and Statistical Manual of Mental Disorders. Multiple Family Group Therapy. The treatment of more than one family unit, at the same time in the same visit, by one or more authorized staff members. There must more than one family member present per family unit and at least one of the family members per family unit must be an identified patient of the center. Neuropsychological Assessment. A battery of performance-based assessments administered by an eligible provider that assesses cognitive functioning and developmental delays, in order to examine the cognitive consequences of brain damage, brain disease, physical, and mental illness, and other conditions that may impact cognitive functioning and achievement of developmental milestones. A neuropsychological assessment may include tests of intelligence, attention and concentration, learning and memory, processing speed, visual spatial perception, language skills, visual motor and fine motor skills, sensory perception, executive functioning, and emotional functioning. Outreach Program. Mental health and substance use disorder treatment services being delivered by a clinical or paraprofessional staff member of the center off the premises of the mental health center or any of its satellite clinics, including, but not limited to, services in members’ homes or other community environments. Parent Clinic. The central location of the mental health center, at which most of the administrative, organizational, and clinical services are performed. Peer Recovery Coach. An individual in addiction recovery who brings lived experience and has completed specialized training to provide nonclinical peer recovery support to members in or seeking recovery. Peer recovery coaches serve as mentors to build hope, explore recovery pathways, and achieve self-directed life goals. Peer recovery coaches also help members navigate systems, overcome barriers, build recovery capital, establish community connections, and link to supportive resources. Peer recovery coaches must meet requirements in 130 CMR 418.000: Substance Use Disorder Treatment Services. Pharmacotherapy. Therapeutic treatment with pharmaceutical drugs. Physician. An individual licensed by the Massachusetts Board of Registration in Medicine in accordance with M.G.L. c. 112, § 2. Preventive Behavioral Health Services. Short-term group interventions, recommended by a physician or other licensed practitioner, practicing within their scope of licensure, that cultivate coping skills and strategies for symptoms of depression, anxiety, and other social/emotional concerns, to prevent the development of behavioral health disorders for children and adolescents younger than 21 years of age. Psychological Assessment. The use of standardized test instruments and procedures to evaluate aspects of a member’s functioning. Psychological assessment includes intelligence, neuropsychological and developmental, and personality assessments. Test instruments used for psychological assessment must be published, valid, and in general use as defined by listing in the Mental Measurements Yearbook or successor publication, or by conformity to the Standards for Educational and Psychological Testing of the American Psychological Association. Quality Management Program. A systematic and ongoing process for monitoring, evaluating, and improving the quality and appropriateness of services provided to members, with focused attention on addressing cultural, ethnic, and language differences. Recovery Support Navigator. A paraprofessional specialist who receives specialized training in the essentials of substance use disorder and evidence-based techniques, such as motivational interviewing, and who supports members in accessing and navigating the substance use disorder treatment system through activities that can include care coordination, case management, and motivational support. Recovery support navigators must meet requirements in 130 CMR 418.000: Substance Use Disorder Treatment Services. Release of Information (ROI). A document that allows a patient to authorize and revoke what information they want to release from their patient record, who it can be released to, how long it can be released for, and under what statutes and guidelines it is released. Satellite Clinic. A clinic at a different location from the parent center that operates under the license of and falls under the fiscal, administrative, and personnel management of the parent center. Structured Outpatient Addiction Program (SOAP): ASAM Level Intensive Outpatient Services. A substance use disorder treatment service that provides short-term, multidisciplinary, clinically intensive structured treatment to address the subacute needs of members with substance use disorders and/or co-occurring disorders. These services may be used as a transition service in the continuum of care toward lower intensity outpatient services or accessed directly. SOAP services must meet requirements in 130 CMR 418.000: Substance Use Disorder Treatment Services. Substance Use Disorder. Any disorder pertaining to substance use as defined by the current edition of the Diagnostic and Statistical Manual of Mental Disorders. Supervised Clinical Experience. A clinician’s experience providing diagnostic and treatment services to individuals, families, and groups of individuals under the direct and continuous supervision of a qualified independently licensed professional as set forth in 130 CMR 429.423, who is employed by the same agency as the supervisee. Telehealth. The use of synchronous or asynchronous audio, video, electronic media, or other telecommunications technology, including, but not limited to interactive audio-video technology; remote patient monitoring devices; audio-only telephone; and online adaptive interviews, for the purpose of evaluating, diagnosing, consulting, prescribing, treating, or monitoring of a member’s physical health, oral health, mental health, or substance use disorder condition. Urgent Behavioral Health Needs. Needs characterized by changes in behavior or thinking, role dysfunction, emerging intent of self-injury, or threats to others. Urgent behavioral health needs do not rise to the level of immediate risk of harm to self or others.