As used in this subchapter, the following definitions apply:

(1) "Care coordination" means monitoring and referral services provided to youth in a PRTF by an outside provider to assist in discharging the youth from the PRTF to create a smooth transition in which to transfer the clinical gains the youth has made in the PRTF to the community. Care coordination may be provided by a licensed or in-training mental health professional, or targeted case manager who has extensive knowledge of community services. In-training mental health professional services are only reimbursed when provided by a licensed mental health center. Care coordination includes the following:

(a) monitoring, which means attending telephonically the youth's monthly PRTF treatment team meetings and consultation with the team about:

(i) the youth's treatment goals and progress in treatment;

(ii) the youth's readiness for discharge and promoting discharge at the earliest opportunity;

(iii) the youth's discharge plan and specific service needs; and

(iv) advocating for the parent or legal guardian's recommendations about treatment and discharge.

(b) referral services, which means:

(i) making appointments for needed psychiatric, medical, educational, psychological, social, behavioral, developmental, and chemical dependency treatment services, as appropriate upon discharge from the PRTF; and

(ii) ensuring communication exists and pertinent clinical information is shared between the youth's PRTF treatment team and community providers prior to discharge.

(2) "Continuity of care payment" means an annual payment made to qualifying hospital-based psychiatric residential treatment facilities (PRTF) according to the eligibility criteria and payment calculation methodology in ARM 37.87.1224.

(3) "Devoted to the provision of inpatient psychiatric care for persons under the age of 21" means an inpatient psychiatric hospital facility or residential treatment facility whose goals, purpose, and care are designed for and devoted exclusively to persons under the age of 21.

(4) "Hospital-based psychiatric residential treatment facility" means a residential treatment facility that meets the requirements of ARM 37.87.1207.

(5) "Inpatient psychiatric services" means psychiatric residential treatment facility, or hospital-based psychiatric residential treatment facility services.

(6) "Patient day" means a whole 24-hour period in which a person is present and receiving inpatient psychiatric services. Even though a person may not be present for a whole 24-hour period, the day of admission and, subject to the limitations and requirements of ARM 37.87.1223, therapeutic home leave days are patient days. The day of discharge is not a patient day for purposes of reimbursement.

(7) "Psychiatric residential treatment facility (PRTF)" means a facility other than a hospital that provides psychiatric services only to individuals under age 21. The PRTF must be certified for Medicaid participation by:

(a) the department as a PRTF; or

(b) the appropriate agency in the state where the facility is located as a PRTF.