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Mental Health CTSS Definitions and Acronyms

Date: 10-01-2014

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Clinical supervision is the process of control and direction of mental health services by which a mental health professional accepts responsibility for the actions and decisions of the person they are supervising, and instructs, oversees and directs their work. The clinical supervisor accepts full professional responsibility and provides on-site observation as clinically appropriate. On-site observations must be at least one hour, documented in the child’s record, and signed by the mental health professional. In addition, the mental health professional must document the child’s progress every 30 days. Clinical supervision may also be provided through a live, secure, electronic site (for example, ITV).

Day treatment: A structured mental health program consisting of group psychotherapy and other intensive therapeutic services (such as skills training) provided by a multidisciplinary team. The goal of day treatment is to reduce or relieve the effects of emotional disturbance or mental illness based on the child’s individual needs. This program must be available all 12 months of the year and a mental health professional must be on site and available more than 50% of the time.

Emotional Disturbance (ED): An organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory, or behavior that is listed in the clinical manual of the International Classification of Diseases (ICD, current edition, code range 290.0 to 302.99 or 306.0 to 316.0 or the corresponding code in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-MD), current edition, and seriously limits a child’s capacity to function in primary aspects of daily living such as personal relations, living arrangements, work, school, and recreation. “Emotional disturbance” is a general term and is intended to reflect all categories of disorder described in the DSM-MD, current edition as “usually first evident in childhood or adolescence.”

Mental Illness: An organic disorder of the brain or a clinically significant disorder of thought, mood, perception, orientation, memory or behavior that is listed in the ICD codes, code range 290.0-302.99 or 306.0-316.0.

Serious and Persistent Mental Illness (SPMI): The child (at least 18, but under age 21), has a diagnosis of mental illness and meets at least one of the following criteria:

  • • Has undergone two or more episodes of inpatient care for mental illness within the preceding 24 months
  • • Has experienced a continuous psychiatric hospitalization or residential treatment longer than six months within the preceding 12 months
  • • Has a diagnosis of schizophrenia, bipolar disorder, major depression, or borderline personality disorder
  • • Shows a significant impairment in functioning, and has a written opinion from a mental health professional stating that he/she is likely to have future episodes requiring inpatient or residential treatment, unless community support program services are provided
  • • Has, in the last three years, been committed by a court as a mentally ill person under Minnesota statutes, or the commitment as a mentally ill person has been stayed or continued
  • • Was eligible under one of the above criteria, but the specified time period has expired or the child was eligible as a child with severe emotional disturbance
  • • Has a written opinion from a mental health professional in the last three years stating that he/she is reasonably likely to have future episodes requiring inpatient or residential treatment of a frequency described in the above criteria, unless ongoing case management or community support services are provided
  • Severe Emotional Disturbance (SED): The child has an emotional disturbance and meets one of the following criteria:

  • • Has been admitted to inpatient treatment or residential treatment or has been at risk of being admitted within the last three years
  • • Is a MN resident and is receiving inpatient treatment or residential treatment for an emotional disturbance through an interstate compact
  • • A mental health professional has determined the child has one of the following– psychosis or clinical depression, risk of harming self or others as a result of emotional disturbance or psychopathological symptoms as a result of being a victim of physical or sexual abuse or psychic trauma within the past year
  • • A mental health professional has determined the child has a significantly impaired home, school or community functioning lasting at least one year or presents a risk of lasting at least one year as a result of emotional disturbance.
  • Telemedicine: A service delivery method provided through electronic communication using interactive telecommunications equipment including, at a minimum, audio and video equipment permitting two-way, real-time, interactive communication between the child and a provider who delivers services from a distant site. Services delivered through telemedicine must be medically necessary and appropriate to this delivery method and the child must be able to benefit from this delivery method.

    Telemedicine may be appropriate for psychotherapy, some skills training, or crisis assistance. Mental Health Behavioral Aide (MHBA) services cannot be provided through telemedicine.

    Children’s Therapeutic Services and Support (CTSS) services covered by Medical Assistance as direct face-to-face services may be provided through telemedicine. Services must be medically appropriate to the condition and needs of the child being served and must meet all IEP service requirements for CTSS services.

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