The following words and terms, when used in this subchapter, shall have the following meaning:

     "Acute psychiatric facility" means a facility that provides inpatient mental health treatment to patients requiring intensive treatment.  The acute psychiatric facility:

• (A) may be located in either a hospital or non-hospital setting;
• (B) is secure; and
• (C) may use:
  • (i) physical, mechanical, or drug restraint ordered by the physician, along with treatment modalities; and
  • (ii) seclusion.

     "Inpatient review" means the process of conducting a formal evaluation by phone to determine whether a child requires acute psychiatric or residential treatment center (RTC) inpatient mental health treatment based on the medical necessity criteria established by OHCA.  • 1

     "Inpatient reviewer" means the person who makes the determination whether a child in the custody of the Oklahoma Department of Human Services (OKDHS) meets the medical necessity criteria for acute psychiatric inpatient care or RTC treatment services.  • 1

     "Medical necessity review" means an assessment of current and recent behaviors and symptoms to determine whether an admission for inpatient mental illness or drug or alcohol dependence treatment constitutes the least restrictive level of care necessary.  The review is performed by a licensed mental health professional.

     "Minor" means any unmarried person younger than 18 years of age.

     "Minor in need of treatment" means a person younger than 18 years of age who is in need of treatment, per Section 5-502 of Title 43A of the Oklahoma Statutes, and who:

• (A) has a demonstrable mental illness or who is drug or alcohol dependent and as a result of that mental illness or dependency is expected within the near future to inflict or attempt to inflict serious bodily harm to himself or herself or another person and has engaged in one or more recent overt acts or made significant recent threats that substantially support that expectation; or
• (B) has a demonstrable mental illness or is drug or alcohol dependent of sufficient severity to cause substantial impairment or disability in at least two of the major areas of functioning in the minor's:
  • (i) family relations;
  • (ii) school performance;
  • (iii) social interactions; or
  • (iv) ability to perform independently the basic tasks of personal hygiene, hydration and nutrition, or self-protection.  A determination regarding the ability of the minor to perform independently such tasks is based upon the age of the minor and the reasonable and appropriate expectation of the minor's ability to perform such tasks.

     "Oklahoma Health Care Authority (OHCA)" means the state agency that administers medical programs reimbursed by the Title XIX Medicaid program and is responsible for the establishment of medical necessity criteria that determine whether an inpatient mental health treatment facility is reimbursed by Title XIX Medicaid.

     "Residential treatment center (RTC)" means a facility that provides residential mental health treatment to residents.  The RTC:

• (A) may be located in either a hospital or non-hospital setting;
• (B) must provide adequate supervision for residents because the RTC is not a secure facility; and
• (C) may use:
  • (i) physical, mechanical, or drug restraint ordered by the physician, along with treatment modalities; and
  • (ii) seclusion.