Title 907 | Chapter 015 | Regulation 005REG


PROPOSED
This document is not yet current.
View Current Regulation
PREVIOUS VERSION
The previous document that this document is based upon is available.
View Previous Version
CABINET FOR HEALTH AND FAMILY SERVICES
Department for Medicaid Services
Division of Health Care Policy
(Amended at ARRS Committee)

907 KAR 15:005.Definitions for 907 KAR Chapter 15.

Section 1.

Definitions.

(1)

"Administrative Services Organization" means a business entity that:

(a)

Is contracted with the department;

(b)

Administers:

1.

Mobile crisis services;

2.

Crisis observation stabilization services;

3.

Behavioral health crisis transportation; and

4.

Associated crisis residential stabilization services.

(c)

Is responsible for:

1.

Oversight of crisis continuum services;

2.

Required reporting related to crisis continuum services;

3.

Billing for crisis continuum services; and

4.

Developing a continuum of crisis services providers that is sufficient to ensure access to mobile crisis services, crisis observation stabilization services, behavioral health crisis transportation, and crisis residential services for all residents of the commonwealth on a twenty-four (24) hour, seven (7) day per week, 365 day per year basis.

(2)

"Adult peer support specialist" means an individual who meets the certification requirements for an adult peer support specialist established in 908 KAR 2:220.

(3)(2)

"Advanced practice registered nurse" or "APRN" is defined by KRS 314.011(7).

(4)(3)

"Approved behavioral health practitioner" means an independently licensed practitioner who is:

(a)

A physician;

(b)

A psychiatrist;

(c)

An advanced practice registered nurse;

(d)

A physician assistant;

(e)

A licensed psychologist;

(f)

A licensed psychological practitioner;

(g)

A certified psychologist with autonomous functioning;

(h)

A licensed clinical social worker;

(i)

A licensed professional clinical counselor;

(j)

A licensed marriage and family therapist;

(k)

A licensed professional art therapist;

(l)

A licensed clinical alcohol and drug counselor; or

(m)

A licensed behavior analyst.

(5)(4)

"Approved behavioral health practitioner under supervision" means an individual under billing supervision of an approved behavioral health practitioner who is:

(a)

 

1.

A licensed psychological associate working under the supervision of a board-approved licensed psychologist;

2.

A certified psychologist working under the supervision of a board-approved licensed psychologist;

3.

A marriage and family therapy associate;

4.

A certified social worker;

5.

A licensed professional counselor associate;

6.

A licensed professional art therapist associate;

7.

A licensed clinical alcohol and drug counselor associate;

8.

A certified alcohol and drug counselor; or

9.

A licensed assistant behavior analyst; and

10.

A behavioral health associate; or

11.

A licensed alcohol and drug counselor; and

(b)

Employed by or under contract with the same billing provider as the billing supervisor.

(6)(5)

"ASAM Criteria" means the most recent edition of "The ASAM Criteria, Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions" published by the American Society of Addiction Medicine.

(7)

"Behavioral health associate" means an individual:

(a)

With a minimum of a Bachelor of Arts or Sciences degree in a human service field;

(b)

Who only provides outpatient services;

(c)

 

1.

 

a.

Who is currently enrolled in a graduate program for a master's degree or doctoral degree in:

a.

Psychology;

b.

Social work; or

c.

a behavioral science field that leads to a credential or license; and

b.

Who is currently participating in an internship or practicum program as part of an accredited educational institution; or

2.

Who is currently working toward a specialized credential or licensure in the field of mental health or substance use disorder, and is employed by a narcotic treatment program;

(d)

Who has a collaborative educational agreement with the graduate program and the employing provider;

(e)

Who complies with the supervision requirements of the collaborative educational agreement and complies with billing supervision requirements for rendering Medicaid servicesThat receives, at a minimum, weekly supervision by an approved behavioral health practitioner employed by the provider of services;

(f)

Who is designated as a behavioral health associate by the department during the application process;

(g)

Who does not render a diagnosis for a client;

(h)

Who is designated as a behavioral health associate for no longer than five (5) years; and

(i)(h)

That is currently employed by one of the following outpatient treatment providers:

1.

A behavioral health services organization;

2.

A behavioral health multi-specialty group;

3.

A certified community behavioral health clinic;

4.

A community mental health center;

5.

A federally qualified Health Center or a federally qualified health center look-alike;

6.

A rural health clinic;

7.

A provider of crisis continuum services, such as:

a.

A mobile crisis intervention service provider;

b.

A crisis observation stabilization unit; or

c.

A behavioral health crisis transportation provider; or

8.

An outpatient behavioral health provider approved by the department.

(8)

"Behavioral health crisis" means any behavioral, substance use disorder, or psychiatric situation perceived to be a crisis by the individual experiencing or witnessing it.

(9)(6)

"Behavioral health multi-specialty group" means a group of more than one (1) individually licensed behavioral health practitioners of varying practitioner types who form a business entity to:

(a)

Render behavioral health services; and

(b)

Bill the Medicaid Program for services rendered to Medicaid recipients.

(10)(7)

"Behavioral health provider group" means a group of more than one (1) individually licensed behavioral health practitioners of the same practitioner type who form a business entity to:

(a)

Render behavioral health services; and

(b)

Bill the Medicaid Program for services rendered to Medicaid recipients.

(11)(8)

"Behavioral health crisis transportation" means the use of a behavioral health support vehicle, to transport a Medicaid recipient alleged to be in a behavioral health crisis to a higher level of care.

(12)

"Behavioral health services organization" means an entity that is licensed as a behavioral health services organization pursuant to:

(a)

902 KAR 20:430 for a behavioral health services organization tier I (BHSO I);

(b)

908 KAR 1:370 and 908 KAR 1:374 for a behavioral health services organization tier II (BHSO II); or

(c)

908 KAR 1:370 and 908 KAR 1:372 for a behavioral health services organization tier III (BHSO III).

(13)(9)

"Behavioral health crisis transport vehicle" means an automobile that:

(a)

Includes a driver's compartment that is separated from the passenger compartment in a way that allows the driver and passenger to communicate and visualize one another but that prohibits the passenger from easily accessing the driver or any control for operating the vehicle; and

(b)

Has a passenger compartment with:

1.

Two (2) or more traditional vehicle seats with appropriate seat belts;

2.

No exposed sharp edges;

3.

Doors that automatically lock and that are not capable of opening while the vehicle is in motion, such as a child lock feature.

(14)

"Billing provider" means the individual, group of individual providers, or organization that:

(a)

Is authorized to bill the department or a managed care organization for a service; and

(b)

Is eligible to be reimbursed by the department or a managed care organization for a service.

(15)(10)

"Billing supervisor" means an individual who is:

(a)

Is:

1.

A physician;

2.

A psychiatrist;

3.

An advanced practice registered nurse;

4.

A physician assistant;

5.

A licensed clinical alcohol and drug counselor;

6.

A licensed psychologist;

7.

A licensed clinical social worker;

8.

A licensed professional clinical counselor;

9.

A licensed psychological practitioner;

10.

A certified psychologist with autonomous functioning;

11.

A licensed marriage and family therapist;

12.

A licensed professional art therapist; or

13.

A licensed behavior analyst;[]and

(b)

Is employed by or under contract with the same billing provider as the behavioral health practitioner under supervision who renders services under the supervision of the billing supervisor;

(c)

Conducts the following supervisory duties and requirements on behalf of the practitioner under supervision:

1.

Records a co-signature on a service note within thirty (30) days; and

2.

Prepares a monthly supervisory note that reflects consultations with the practitioner or paraprofessional working under supervision that includes the supervising professional's evaluation of the services being provided to each recipient;

(d)

Is not required to be the same provider type as the practitioner under supervision.

(16)(11)

"Certified alcohol and drug counselor" is defined by KRS 309.083309.080(2).

(17)(12)

"Certified psychologist" means an individual who is a certified psychologist pursuant to KRS 319.056.

(18)(13)

"Certified psychologist with autonomous functioning" means an individual who is a certified psychologist with autonomous functioning pursuant to KRS 319.056.

(19)(14)

"Certified social worker" means an individual who meets the requirements established in KRS 335.080.

(20)(15)

"Chemical dependency treatment center" means an entity that is licensed as a chemical dependency treatment center pursuant to 902 KAR 20:160.

(21)

"Community-based mobile crisis intervention services" or "(MCIS)" means a dispatch of a mobile crisis team to the location of an individual who is experiencing a behavioral health crisis.

(22)(16)

"Community support associate" means a paraprofessional who meets the application, training, and supervision requirements of 908 KAR 2:250.

(23)(17)

"Co-occurring disorder" means a mental health and substance use disorder.

(24)(18)

"Department" means the Department for Medicaid Services or its designee.

(25)(19)

"Electronic signature" is defined by KRS 369.102(8).

(26)(20)

"Enrollee" means a recipient who is enrolled with a managed care organization.

(27)(21)

"Face-to-face" means occurring in person.

(28)(22)

"Family peer support specialist" means an individual who meets the certification requirements for a Kentucky family peer support specialist established in 908 KAR 2:230.

(29)(23)

"Federal financial participation" is defined by 42 C.F.R. 400.203.

(30)(24)

"Healthcare common procedure coding system" or "HCPCS" means a collection of codes acknowledged by the Centers for Medicare and Medicaid Services (CMS) that represents procedures or items.

(31)(25)

"Kentucky-specific Medicare Physician Fee Schedule" means the list or process by which current reimbursement rates for physician services are established or published by the department.

(32)(26)

"Level I psychiatric residential treatment facility" means an entity that is licensed as a Level I psychiatric residential treatment facility pursuant to 902 KAR 20:320.

(33)(27)

"Level II psychiatric residential treatment facility" means an entity that is licensed as a Level II psychiatric residential treatment facility pursuant to 902 KAR 20:320.

(34)(28)

"Licensed assistant behavior analyst" is defined by KRS 319C.010(7).

(35)(29)

"Licensed behavior analyst" is defined by KRS 319C.010(6).

(36)(30)

"Licensed clinical alcohol and drug counselor" is defined by KRS 309.080(8)(4).

(37)(31)

"Licensed clinical alcohol and drug counselor associate" is defined by KRS 309.080(9)(5).

(38)(32)

"Licensed clinical social worker" means an individual who meets the licensed clinical social worker requirements established in KRS 335.100.

(39)(33)

"Licensed marriage and family therapist" is defined by KRS 335.300(2).

(40)(34)

"Licensed professional art therapist" is defined by KRS 309.130(2).

(41)(35)

"Licensed professional art therapist associate" is defined by KRS 309.130(3).

(42)(36)

"Licensed professional clinical counselor" is defined by KRS 335.500(3).

(43)(37)

"Licensed professional counselor associate" is defined by KRS 335.500(4).

(44)(38)

"Licensed psychological associate" means an individual who meets the requirements established in KRS 319.064.

(45)(39)

"Licensed psychological practitioner" means an individual who meets the requirements established in KRS 319.053.

(46)(40)

"Licensed psychologist" means an individual who currently possesses a licensed psychologist license in accordance with KRS 319.010(6) and (9).

(47)(41)

"Managed care organization" means an entity for which the Department for Medicaid Services has contracted to serve as a managed care organization as defined by 42 C.F.R. 438.2.

(48)(42)

"Marriage and family therapy associate" is defined by KRS 335.300(3).

(49)(43)

"Medicaid-covered service" means a service covered by the department as established in Title 907 of the Kentucky Administrative Regulations.

(50)(44)

"Medically necessary" or "medical necessity" means that a covered benefit is determined to be needed in accordance with 907 KAR 3:130.

(51)(45)

"Medication assisted treatment" means the treatment of a substance use disorder with approved medications in combination with counseling, behavioral therapies, and other supports.

(52)

"Mobile crisis team" means a professional working group that performs a mobile crisis intervention service prior to provision of a behavioral health secure transportation service and that consists of at least:

(a)

One (1) approved behavioral health practitioner who is licensed to perform an assessment; and

(b)

One (1) approved behavioral health practitioner or approved behavioral health practitioner under supervision.

(53)(46)

"Physician" is defined by KRS 205.510(12)(11).

(54)(47)

"Physician assistant" is defined by KRS 311.840(3).

(55)(48)

"Practitioner working under supervision" means:

(a)

An approved behavioral health practitioner under supervision;

(b)

A registered behavior technician;

(c)

A community support associate; or

(d)

A peer support specialist; or

(e)

A targeted case manager, as established pursuant to this chapter.

(56)(49)

"Provider" is defined by KRS 205.8451(7).

(57)(50)

"Provider abuse" is defined by KRS 205.8451(8).

(58)(51)

"Psychiatric hospital" means an entity licensed as a psychiatric hospital pursuant to 902 KAR 20:180.

(59)(52)

"Recipient" is defined by KRS 205.8451(9).

(60)(53)

"Recipient abuse" is defined by KRS 205.8451(10).

(61)(54)

"Recipient's representative" means:

(a)

For a recipient who is authorized by Kentucky law to provide written consent, an individual acting on behalf of, and with written consent from, the recipient; or

(b)

A legal guardian.

(62)(55)

"Registered alcohol and drug peer support specialist" is defined by KRS 309.080(8).

(63)(56)

"Registered behavior technician" means an individual who meets the following requirements provided by the Behavior Analyst Certification Board:

(a)

Be at least eighteen (18) years of age;

(b)

Have a high school diploma or its equivalent; and

(c)

Within six (6) months of hire for a new employee or within six (6) months of the effective date of this administrative regulation for an existing employee:

1.

Complete a training program that is:

a.

Approved by the Behavior Analyst Certification Board;

b.

Based on the current edition of the RBT Task List endorsed by the Behavior Analyst Certification Board; and

c.

Conducted by Behavior Analyst Certification Board certificants;

2.

Pass the Registered Behavior Technician Competency Assessment administered by a Behavior Analyst Certification Board certificant or by an assistant assessor overseen by a Behavior Analyst Certification Board certificant; and

3.

Pass the Registered Behavior Technician exam provided by the Behavior Analyst Certification Board.

(64)(57)

"Registered nurse" is defined by KRS 314.011(5).

(65)(58)

"Residential crisis stabilization unit" means an entity that is licensed as a residential crisis stabilization unit pursuant to 902 KAR 20:440.

(66)(59)

"Section 504 plan" means a plan developed:

(a)

Under the auspices of Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C. 794 (Section 504); and

(b)

To ensure that a child who has a disability identified under the law and is attending an elementary or secondary educational institution receives accommodations to ensure the child's academic success and access to the learning environment.

(67)(60)

"Telehealth" is defined by KRS 205.510(16)(15).

(68)(61)

"Withdrawal management" means a set of interventions aimed at managing acute intoxication and withdrawal based on the severity of the illness and co-occurring conditions identified through a comprehensive biopsychosocial assessment with linkage to addiction management services, and incorporated into a recipient's care as needed throughout the appropriate levels of care.

(69)(62)

"Youth peer support specialist" means an individual who meets the requirements established for a Kentucky youth peer support specialist established in 908 KAR 2:240.

Section 2.

This administrative regulation was found deficient by the Administrative Regulation Review Subcommittee on October 15, 2024.

FILED WITH LRC: October 15, 2024
CONTACT PERSON: Krista Quarles, Policy Analyst, Office of Legislative and Regulatory Affairs, 275 East Main Street 5 W-A, Frankfort, Kentucky 40621; phone 502-564-6746; fax 502-564-7091; email CHFSregs@ky.gov.

7-Year Expiration: 1/3/2027

Last Updated: 10/31/2024


Page Generated: 9/19/2024, 12:15:11 PM