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(1) "Active treatment" means:

(a) for persons with mental retardation or a related condition, a continuous program which includes aggressive consistent implementation of a program of specialized and generic training, treatment, health services and related services that is directed toward:

(i) the acquisition of the behaviors necessary for the person to function with as much self-determination and independence as possible; and

(ii) the prevention or deceleration of regression or loss of current optimal functional status. Active treatment does not include services to maintain a generally independent client who is able to function with little supervision or in the absence of a continuous treatment program.

(b) for persons with mental illness, the implementation of an individualized plan of care developed under and supervised by a physician and provided by physicians and other qualified mental health professionals, that prescribes specific therapies and activities under the supervision of trained mental health personnel for the treatment of a person who is experiencing an acute episode of severe mental illness.

(2) "Home and community services program" means the provision of services described in ARM 46.12.1401 through 46.12.1482 to a person in a community setting, who meets the nursing facility level of care requirements.

(3) "Level I screening" means a review of a nursing facility applicant to identify whether the applicant has a primary or secondary diagnosis or indications of mental retardation or of mental illness.

(4) "Level II screening" means an assessment applied to persons identified as having a primary or secondary diagnosis of mental retardation or mental illness which determines whether the person as a nursing facility applicant has need for the level of services provided by the nursing facility or by another type of facility and, if so, whether the individual requires active treatment.

(5) "Medicaid recipient" means a person who is currently medicaid eligible or who has applied for medicaid.

(6) "Mental illness" means an applicant has or has had a primary or secondary diagnosis of a major mental disorder, as defined in the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSMIIIR) , limited to schizophrenic, paranoid, major affective, schizoaffective disorders and atypical psychosis, and does not have a primary diagnosis of dementia, including Alzheimer's disease or a related disorder, which is based on a neurological assessment.

(7) "Mental retardation" means:

(a) An applicant has or has had a primary or secondary diagnosis of mild, moderate, severe or profound retardation as described in the American Association on Mental Deficiency's Manual on Classification in Mental Retardation (1983) ; or

(b) An applicant has, or has had a primary or secondary diagnosis of a condition related to mental retardation, which is a severe, chronic disability that:

(i) is attributable to:

(A) autism, cerebral palsy or epilepsy; or

(B) any other condition, other than mental illness found to be closely related to mental retardation due to an impairment of general intellectual functioning or adaptive behavior similar to that of mentally retarded persons requiring treatment or services similar to those required for these persons;

(ii) is manifested before the person reaches age 22;

(iii) is likely to continue indefinitely; and

(iv) results in substantial functional limitations in three or more of the following areas of major life activity:

(A) self-care;

(B) understanding and use of language;

(C) learning;

(D) mobility;

(E) self-direction or;

(F) capacity for independent living.

(8) "Nursing facility" means an institution or a distinct part of an institution which is not primarily for the care and treatment of mental diseases, and is primarily engaged in providing either:

(a) skilled nursing care and related services for residents who require medical or nursing care;

(b) rehabilitation services for the rehabilitation of injured, disabled or sick persons, or

(c) on a regular basis, health-related care and services to persons who because of their mental or physical condition require care and services above the level of room and board which can be made available to them only through institutional


(9) "Nursing facility applicant" means any person who has been referred for or is applying for admission to a nursing facility or the home and community services program.

(10) "Preadmission screening" means a medical, psychological and social evaluation of a nursing facility applicant which:

(a) is performed prior to entry to a nursing facility or the home and community services program and includes;

(i) a level I screening to determine if an applicant has a diagnosis or indication of mental illness or mental retardation;

(ii) a level II screening if an applicant is found by the level I screening to need further assessment; and

(iii) a nursing facility screening which determines an applicant's need for nursing facility services.

(11) "Preadmission screening team" means:

(a) for a nursing facility services determination, a licensed registered nurse and a department long term care specialist;

(b) for a level I screening, a long term care specialist or other professional approved by the department; and

(c) for a level II screening, employees or contractors of the state mental retardation authority or the state mental health authority.

(12) "Problems" means functional impairments, including those involving walking, bathing, grooming, dressing, toileting, transferring, feeding, bladder incontinence, bowel incontinence, special sense impairments (such as speech or hearing) , mental and behavioral dysfunctions.

(13) "State mental health authority" means the Montana department of corrections.

(14) "State mental retardation authority" means the developmental disabilities division of the Montana department of public health and human services.

History: Sec. 53-2-201, 53-5-205, 53-6-113 and 53-6-402, MCA; IMP, Sec. 53-2-201, 53-6-101, 53-6-111, 53-6-131, 53-6-141 and 53-6-402, MCA; NEW, 1983 MAR p. 863, Eff. 7/15/83; EMERG, AMD, 1989 MAR p. 439, Eff. 4/14/89; TRANS, from SRS, 2000 MAR p. 489.

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