Title 7 . Health and Social Services

Chapter 43 . Hearings

Section 1990. Definitions

7 AAC 43.1990. Definitions

In this chapter, unless the context requires otherwise,

(1) "active treatment" means the planning, delivery, and monitoring of a dynamic set of interrelated, effective, culturally appropriate, individualized mental health rehabilitation and related support services that

(A) are designed to meet the mental health service needs of the recipient;

(B) use a specific and clear intervention strategy targeting behaviors identified in an intake assessment and individualized treatment plan;

(C) are designed to improve functioning, reduce or eliminate negative symptoms, demonstrate ongoing measurable progress, and enhance the quality of the recipient's life;

(D) are provided by qualified staff to a recipient who is an active participant in the treatment process; and

(E) have a goal more specific than simply the avoidance of institutional care;

(2) "adjustment/void request form" means the form that a provider submits to the division to

(A) change a paid claim line that was billed or processed incorrectly;

(B) void a paid claim line; or

(C) repay an overpayment to the division;

(3) "admitting history and physical examination" means a comprehensive review and examination of a recipient upon admission to an inpatient psychiatric hospital facility to determine and record the recipient's

(A) medical history;

(B) developmental history;

(C) social history;

(D) present illness or illnesses;

(E) basic physical health by means of a complete physical examination;

(F) medication history; and

(G) allergies, if any;

(4) "APA" means the Adult Public Assistance program administered by the division under AS 47.25.430 - 47.25.615;

(5) "AFDC" means the Aid to Families with Dependent Children assistance program formerly administered by the division under former AS 47.25.310 - 47.25.420;

(6) "ATAP" means the Alaska Temporary Assistance Program administered by the division under AS 47.27;

(7) "care coordination" means those services necessary to promote overall maintenance of the recipient's physical survival, personal growth, community participation, and recovery from substance abuse; "care coordination" includes coordinating assessment and treatment services, facilitating access to appropriate and necessary services, assessing recipient skill level, providing treatment and crisis assistance planning, providing linkage between the recipient's needs and services, coordinating the training of the recipient in the use of basic community resources, monitoring the overall provision of service and the recipient's progress, providing social support, promoting treatment or community adjustment, providing advocacy to ensure that services are appropriate to the recipient's needs, and providing outreach services necessary to assist the recipient in obtaining benefits to which the recipient is entitled;

(8) "case management" means a mental health rehabilitation service described in 7 AAC 43.737 provided by enrolled providers to recipients under 7 AAC 43.470(e) or 7 AAC 43.734(c) that assists the recipient and the recipient's family in the access and coordination of needed medical, psychiatric, mental health, educational, vocational, social supports, community-based services, related assessments, and post-discharge follow-up activities;

(9) "central office" means the central office of the division;

(10) "chronically mentally ill adult" means an individual 21 years of age or older

(A) who has been diagnosed as having a schizophrenic, major affective, or paranoid disorder, or other severe mental disorder with a documented history of persistent psychotic symptoms not caused by substance abuse; and

(B) whose role functioning is impaired in at least two of the following three ways:

(i) inability to function independently in the role of worker, student, or homemaker;

(ii) inability to engage independently in personal care or community living activities; or

(iii) inability to exhibit appropriate social behavior, resulting in intervention by the mental health system or judicial system;

(11) "commission" means the Medicaid rate advisory commission established by AS 47.07.110 - 47.07.190;

(12) "community mental health clinic" means a program headed by a physician, who may be a psychiatrist, or headed by a psychologist or mental health professional clinician working under the general direction of a physician, that provides mental health services and operates under the provisions of 7 AAC 71.010 - 7 AAC 71.220 or as a state-operated community mental health clinic;

(13) "continuous home care" means care provided during a period of crisis in which a recipient requires constant care to reduce or manage acute medical symptoms as necessary to maintain a recipient at home;

(14) "crisis intervention" means short-term mental health services provided to a recipient during an acute episode of a mental, emotional, or behavioral disorder, that are intended to reduce the symptoms of the disorder, prevent harm to the recipient or others, prevent further relapse or deterioration of the recipient's condition, or stabilize the recipient;

(15) "day treatment services" means a combined program of therapeutic and academic services coordinating mental health services and resources with school district services and resources to assist a recipient who is a severely emotionally disturbed child to improve the recipient's daily functioning within, or make a transition to, the community-based school environment; day treatment services may include a specific mental health component that provides counseling, monitoring, and support necessary to keep the child within the community-based school environment;

(16) "department" means the Department of Health and Social Services;

(17) "director" means the director of the division;

(18) "direct supervision" means that, in a mental health physician clinic, a psychiatrist is on the premises to deliver medical services at least 60 percent of the time the clinic is open for providing medical services, and for an additional time needed to meet all of the following medical responsibilities:

(A) sees each recipient at least once, prescribes the care to be provided, approves the individualized treatment plan in writing, and at least every six months reviews each case to determine the need for continued care;

(B) provides direct clinical consultation and supervision to clinic staff;

(C) assumes professional responsibility for the services provided and assures that the services are medically appropriate;

(19) "dispensing provider" means one of the following entities, if that entity dispenses drugs as part of a medical practice, does not employ a pharmacist to dispense drugs, and is not enrolled with Medicaid as an outpatient pharmacy:

(A) a physician;

(B) an advanced nurse practitioner;

(C) a rural health clinic that meets the requirements of 7 AAC 43.850;

(D) a federally qualified health center that meets the requirements of 7 AAC 43.870;

(E) an Indian Health Service facility as described in 42 U.S.C. 1396j;

(20) "division" means the division of medical assistance of the Department of Health and Social Services;

(21) "emotionally disturbed adult" means an individual 21 years of age or older who is diagnosed as having a mental disorder with nonpersistent nonpsychotic symptoms and whose role functioning is not significantly impaired, or is impaired in no more than one of the following three ways; for purposes of this paragraph, "mental disorder" does not include mental retardation or a substance abuse disorder:

(A) inability to function independently in the role of worker, student, or homemaker;

(B) inability to engage independently in personal care or community living activities;

(C) inability to exhibit appropriate social behavior, resulting in intervention by the mental health system or judicial system;

(22) "emotionally disturbed child" means an individual under 21 years of age who

(A) has a mental, emotional, or behavioral disorder that

(i) is identified during an intake assessment;

(ii) is not the result of intellectual, physical, or sensory deficits; and

(iii) disrupts the individual's ability to function within the individual's home, school, or other educational setting, within the individual's community, or within the individual's family or other significant interpersonal relationships; and

(B) requires mental health services to meet the identified needs of the individual and the individual's family;

(23) "EPSDT" means the early periodic screening, diagnosis, and treatment program under Medicaid;

(24) "facility" means the same thing as "health facility" in AS 47.07.900 ;

(25) "family counseling" means the provision of a counseling session conducted by one or more counselors for the recipient and members of the recipient's immediate or extended family or social network;

(26) "family psychotherapy" means a form of therapy in which members of a family or any two or more individuals sharing a household, one of whom is a Medicaid recipient, attend psychotherapy sessions together for the treatment of relationships within the family or household to achieve better emotional, behavioral, or social adjustments of all the individuals within the family or household;

(27) "family skill development services" means face-to-face therapeutic skill instruction, skill practice, and skill monitoring that is

(A) provided to a single recipient who is a severely emotionally disturbed child and to the family of that recipient;

(B) provided in the family home, or in the clinic or other location;

(C) included in the recipient's individualized treatment plan; and

(D) designed to help the family and the recipient learn more effective ways to impact the recipient's symptoms and inappropriate behavior;

(28) "freestanding facility" means a facility that is individually licensed and enrolled to provide health care services independent from administrative or financial control of another facility;

(29) "functional assessment" means a systematic evaluation of a recipient to assess that recipient's functioning level in the areas of living skills, learning, education, work, interpersonal skills, and other life skills necessary for independent living, in order to develop an individualized written treatment plan;

(30) "general direction" means that, in a community mental health clinic, a physician

(A) is on the premises to deliver consultative and treatment services at least one day per month unless the division, in its discretion, determines that travel conditions have prevented transportation access, and at other times is readily available by telephone for program and case consultation;

(B) provides general program and clinical consultation to clinic staff to ensure that services are medically necessary, as determined in accordance with 7 AAC 43.486; and

(C) provides pharmacologic management to recipients on psychotropic medications, and provides treatment or consultative services to other recipients upon referral;

(31) "general inpatient care" means care provided in a participating hospice inpatient unit or a participating hospital or nursing facility that meets the standards for staffing and patient areas in 42 C.F.R. 418.98 or 42 C.F.R. 418.100, revised as of October 1, 1994 and adopted by reference, for procedures necessary for pain control or acute or chronic symptom management that cannot feasibly be provided in another setting;

(32) "group counseling" means the provision of a counseling session conducted by one or more counselors for two or more unrelated recipients;

(33) "group psychotherapy" means a form of psychotherapy in which two or more individuals participate together in the presence of one or more psychotherapists;

(34) "group skill development services" means face-to-face therapeutic skill instruction, skill practice, and skill monitoring, offered in a group setting, designed to help the recipient develop or improve specific self-care, self-direction, communication, or social-interaction skills necessary for successful community adjustment and interaction with persons in the recipient's home, school, work, or community environment;

(35) "home and community-based services waiver" means a waiver granted under 42 U.S.C. 1396n(c);

(36) "hospital" means a facility licensed by the department to provide inpatient and outpatient hospital services;

(37) "ICF" means a facility certified as an intermediate care facility;

(38) "ICF/MR" means a facility certified as an intermediate care facility for the mentally retarded or individuals with related conditions;

(39) "individual counseling" means the provision of a counseling session conducted by one counselor for one recipient;

(40) "individual psychotherapy" means any form of treatment for mental illness, behavioral maladaptation, or other problems that are assumed to be of an emotional nature, in which a trained individual deliberately establishes a professional relationship with an individual for the purpose of removing, modifying, or retarding existing symptoms, attenuating or reversing disturbed patterns of behavior, and promoting positive personality growth and development;

(41) "individual skill development services" means face-to-face therapeutic self-care and life skill instruction, skill practice, and skill monitoring, provided individually, and designed to help the recipient develop or improve specific self-care skills, engage in age-appropriate social behavior, maintain the recipient's household, and develop the ability to be independently mobile within the recipient's community;

(42) "individualized treatment plan" means a written document that

(A) is developed in cooperation with the recipient and other members of any interdisciplinary team organized under 7 AAC 43.470; and

(B) includes, at minimum, the components identified in 7 AAC 43.728;

(43) "inpatient interdisciplinary team" means a team composed of physicians and other personnel who are employed by an inpatient psychiatric hospital facility, a residential psychiatric treatment center, or an individual who renders services to recipients in either facility;

(44) "inpatient psychiatric hospital facility" means a facility or part of a facility, other than a residential psychiatric treatment center, that is licensed as a hospital under AS 18.20 and that primarily delivers inpatient psychiatric services;

(45) "inpatient psychiatric services" means diagnostic and treatment services for mental, behavioral, and emotional disorders provided in an inpatient psychiatric hospital facility that meets the conditions for payment under 7 AAC 43.560(a) , or provided in a residential psychiatric treatment center that meets the conditions for payment under 7 AAC 43.560(b) ;

(46) "inpatient respite care" means a short-term admission of no more than five days for inpatient care in a facility that meets the standards in 42 C.F.R. 418.98(b), revised as of October 1, 1994 and adopted by reference, in order to provide relief to the caregiver; "inpatient respite care" does not include care provided to a recipient residing in a nursing home or intermediate care facility for the mentally retarded;

(47) "intake assessment" means a systematic evaluation of a recipient upon admission to services, and periodically during the course of treatment, to assess and document mental status, social and medical history, the presenting problems and related symptoms, the recipient's strengths and resources, and service needs of the recipient for the purposes of establishing a diagnosis and developing an individualized treatment plan;

(48) "interdisciplinary group" means a group of individuals designated by a hospice who provide or supervise the care and services offered by the hospice;

(49) "Medicaid" means the medical assistance program administered by the division under 42 U.S.C. 1396 - 1396v and AS 47.07;

(50) "medical practice review section" means that section of the division responsible for prior authorization, medical review, and utilization review of medical services;

(51) "Medicare" means the medical assistance program administered by the federal government through private health insurance companies under 42 U.S.C. 1395 - 1395ggg;

(52) "medication administration services" means the administration, by appropriately licensed medical personnel, of injectable or oral medications to a recipient, and documentation of medication compliance, assessment and documentation of side effects, and evaluation and documentation regarding the effectiveness of the medication;

(53) "medication management" has the meaning given in this section for "pharmacologic management";

(54) "mental health clinical associate" means an individual who may have less than a master's degree in psychology, social work, counseling, or a related field with specialization or experience in working with chronically mentally ill adults or severely emotionally disturbed children, whose responsibilities may include psychosocial evaluation, individual skill development services, recipient support services, group skill development services, family skill development services, or day treatment services, and who works within the scope of the individual's training and experience, and under the direction of a mental health professional clinician, physician, or psychiatrist in a community mental health clinic;

(55) "mental health physician clinic" means a clinic, operated by one or more psychiatrists, that exclusively or primarily provides mental health services furnished by a psychiatrist or by one or more

(A) psychologists, psychological associates, clinical social workers, nurse practitioners, or psychiatric nursing clinical specialists who are licensed to practice in the state in which the service is provided;

(B) marital and family therapists who are licensed under AS 08.63 or in a state with requirements substantially similar to the requirements of AS 08.63 where services are provided, and who work in their field of expertise under the direct supervision of a psychiatrist; or

(C) professional counselors who are licensed under AS 08.29 or in a state with requirements substantially similar to the requirements of AS 08.29 where services are provided, and who work in their field of expertise under the direct supervision of a psychiatrist;

(56) "mental health professional clinician" means

(A) an individual with a master's degree or more advanced degree in psychology, social work, counseling, child guidance, or nursing with specialization or experience in mental health who, if employed by a mental health physician clinic, is licensed to practice in the state in which the service is provided;

(B) a marital and family therapist who is licensed under AS 08.63 or in a state with requirements substantially similar to the requirements of AS 08.63 where services are provided, and who works in the individual's field of expertise; or

(C) a professional counselor who is licensed under AS 08.29 or in a state with requirements substantially similar to the requirements of AS 08.29 where services are provided, and who works in the individual's field of expertise;

(57) "OASDI" means the old-age, survivors, and disability insurance benefits program administered by the federal government under 42 U.S.C. 401 - 426-1;

(58) "part A of Medicare" means that portion of the Medicare program providing coverage for hospital care under 42 U.S.C. 1395c - 1395i-5;

(59) "part B of Medicare" means that portion of the Medicare program providing coverage for physician and outpatient care under 42 U.S.C. 1395j - 1395w-4;

(60) "pharmacologic management" means assessing a recipient's need for pharmacotherapy and prescribing appropriate medications to meet the recipient's need by a physician, a physician's assistant, or an advanced nurse practitioner with prescriptive authority, and monitoring the recipient's response to medication by appropriately licensed medical professionals, including documentation of medication compliance, assessment and documentation of side effects, and evaluation and documentation regarding the effectiveness of the medication;

(61) "physician collaborator" means

(A) an advanced nurse practitioner, physician assistant, physical therapist, occupational therapist, or audiologist who is licensed or registered under AS 08 and who practices within the scope of that license or registration; or

(B) a speech pathologist who meets the requirements of 7 AAC 43.926(a) (1)(A);

(62) "prior authorization" means approval by the department of a certain type and number of units of Medicaid-covered services before those services are provided;

(63) "PRO" means a professional review organization consisting of an independent team of medical professionals, including at least one physician, who have competence in the treatment and diagnosis of mental illness, and who operate under an agreement with the state to provide preadmission screenings and utilization review services;

(64) "provider" means an individual, firm, corporation, association, or institution that provides, or has been approved to provide, medical assistance to a recipient under Medicaid;

(65) "psychiatric assessment" means a systematic evaluation of a recipient to determine symptomatology, establish a diagnosis, and prescribe needed treatment;

(66) "psychiatric facility" means a licensed hospital facility or part of a licensed hospital facility that is primarily for the diagnosis and treatment of mental, emotional, or behavioral disorders;

(67) "psychiatrist" means a physician licensed to practice medicine in the state in which services are provided, and who has completed a fully qualified residency in psychiatry;

(68) "psychological associate" means an individual licensed in the state in which services are provided, who renders specific mental health services in association with a licensed psychologist within the scope of practice identified in 12 AAC 60.185;

(69) "psychological testing and evaluation" means the administration of standardized psychological tests and interpretation of findings by a psychologist, psychological associate, or other mental health professional clinician with appropriate education and training, for the purpose of providing assistance in the psychiatric diagnosis of mental and emotional disorders or the assessment of functional capabilities;

(70) "psychologist" means an individual who is licensed to practice psychology in the state in which services are provided;

(71) "psychosocial assessment" has the meaning given in this section for "functional assessment";

(72) "recipient" means an individual for whom payment is made under the Medicaid program;

(73) "recipient's representative" means a parent, guardian, or other individual with legal authority to act on the recipient's behalf;

(74) "recipient support services" means face-to-face counseling to provide structure, supervision, and monitoring necessary to maintain and protect a severely emotionally disturbed child or adult, or a chronically mentally ill adult recipient within the recipient's home, workplace, school, and community and prevent harm to the recipient or to others; "recipient support services" does not include those daily supervisory activities that a parent or foster parent would normally carry out to assure protection, emotional support, and care of a child who is not a severely emotionally disturbed child, or those daily supervisory activities normally provided by or within an assisted living facility, congregate housing facility, or group home for care of an adult who is not a severely emotionally disturbed adult or is not a chronically mentally ill adult;

(75) "recoupment" means an action by the division to recover an overpayment by reducing future payments to the provider until the amount of the overpayment has been offset;

(76) "regional office" means that office of the division responsible for the administration of division programs within a particular geographic region of the state;

(77) "rehabilitation treatment services" means a program of treatment services that are provided, either individually or in a group setting, to a recipient of substance abuse treatment, with the objective of improving the functioning level of the recipient through supporting or strengthening the behavioral, emotional, or intellectual skills necessary to live, learn, or work in the recipient's environment;

(78) "residential psychiatric treatment center" means a freestanding facility that

(A) provides residential child care and inpatient psychiatric services for the diagnosis and treatment of child and adolescent mental, emotional, or behavioral disorders;

(B) is licensed under 7 AAC 50;

(C) meets the requirements of 7 AAC 43.560(b) ; and

(D) is not a provider eligible for payment under 7 AAC 43.670 - 7 AAC 43.709;

(79) "routine home care" means any combination of the services listed in 7 AAC 43.938(c) (1)-(c)(9) and (c)(12) provided to a recipient electing hospice care that are not provided at the level and intensity of continuous home care;

(80) "severely emotionally disturbed adult" means an individual 21 years of age or older who is diagnosed as having a severe personality disorder, organic disorder, or other mental disorder with persistent nonpsychotic symptoms and who, as the result of the disorder, has impairment in role functioning in at least two of the following three ways:

(A) inability to function independently in the role of worker, student, or homemaker;

(B) inability to engage independently in personal care or community living activities;

(C) inability to exhibit appropriate social behavior, resulting in intervention by the mental health system or judicial system;

(81) "severely emotionally disturbed child" means an individual under 21 years of age who meets the requirements of 7 AAC 43.471(a) and who has a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria set out in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition, Text Revision, dated 2000 (DSM-IV-TR) and adopted by reference, that has resulted in at least moderate functional impairment, as defined in 7 AAC 43.471(b) , that substantially interferes with or limits the child's role functioning in family, school, or community activities, and that has been present for at least six months; for purposes of this paragraph, "mental, behavioral, or emotional disorder"

(A) includes attention-deficit and disruptive behavior disorders as defined in (DSM-IV-TR); and

(B) does not include DSM-IV-TR "V" codes, substance use, and developmental disorders;

(82) "SNF" means a facility certified as a skilled nursing facility;

(83) "SSI" means the Supplemental Security Income program administered by the federal government under 42 U.S.C. 1381-1383c;

(84) "treatment plan review" means the process of reviewing and documenting the recipient's response to treatment, and progress toward the goals outlined in the treatment plan, on a scheduled quarterly basis, documented as required under 7 AAC 43.728, with active participation by the recipient, the recipient's family, the recipient's treatment providers, or other individuals involved in recipient's treatment;

(85) "utilization and quality control peer review organization" means an organization administered by a grant agency of the federal government and defined under 42 U.S.C. 1320c-1;

(86) "ambulatory services" means non-institutional services that are payable under Medicaid and provided in accordance with this chapter; "ambulatory services" include

(A) visual care;

(B) speech;

(C) hearing;

(D) language;

(E) EPSDT;

(F) podiatry;

(G) nutrition;

(H) private duty nursing;

(I) hospice;

(J) family planning;

(K) physical therapy;

(L) occupational therapy;

(M) chiropractic; and

(N) services that are not primary care services, that are provided by a physician, physician assistant, or advanced nurse practitioner, that are within the scope of that individual's license to practice, and that are

(i) provided in or by a hospital; or

(ii) laboratory or X-ray services only;

(87) "category of service" means a type of Medicaid covered service that is furnished in a rural health clinic or a federally qualified health center;

(88) "clinical social worker" means an individual licensed as a clinical social worker under AS 08.95;

(89) "cost center" means a breakout of costs on the Medicare cost report related to a particular type of service or administrative function at the facility;

(90) "federally qualified health center" means a facility that has filed an agreement with the department to provide federally qualified health center services under Medicaid;

(91) "federally qualified health center visit" means the aggregate of face-to-face encounters, occurring on the same calendar day and at a single location, between a federally qualified health center patient and one or more federally qualified health center professionals; for purposes of this paragraph, "aggregate of face-to-face encounters" does not include

(A) multiple face-to-face encounters in which, after the first encounter, the patient suffers an additional illness or injury requiring additional diagnosis or treatment;

(B) a face-to-face encounter for dental or mental health diagnosis or treatment that occurs on the same calendar day and single location as one or more face-to-face encounters for medical diagnosis or treatment; or

(C) charity care as defined in 7 AAC 43.860(p) (1);

(92) "increase or decrease in the scope of services" means

(A) the addition of a category of service to, or the deletion of a category of service from, those categories of service that a rural health clinic or federally qualified health center provides;

(B) an increase or decrease, that may be reasonably expected to span at least one year, in the intensity of a category of service provided by a rural health clinic or federally qualified health center; in this subparagraph, "intensity" means the cost of a category of service due to a change in the level of medical care provided to the population served by the rural health clinic or federally qualified health center;

(93) "Medicare cost report" means the uniform cost report that a facility must prepare under 42 C.F.R. 413.20 - 413.24;

(94) "primary care" means the provision of professional comprehensive health services that includes health education and disease prevention, initial assessment of health problems, treatment of acute and chronic health problems, and the overall management of an individual's or family's health care services;

(95) "rural health clinic" means a facility that has filed an agreement with the department to provide rural health clinic services under Medicaid;

(96) "rural health clinic visit" means the aggregate of face-to-face encounters, occurring on the same calendar day and at a single location, between a rural health clinic patient and one or more rural health clinic professionals; for purposes of this paragraph, "aggregate of face-to-face encounters" does not include

(A) multiple face-to-face encounters in which, after the first encounter, the patient suffers an additional illness or injury requiring additional diagnosis or treatment;

(B) a face-to-face encounter for dental or mental health diagnosis or treatment that occurs on the same calendar day and single location as one or more face-to-face encounters for medical diagnosis or treatment; or

(C) charity care as defined in 7 AAC 43.860(p) (1);

(97) "therapeutic transition day" means a calendar day related to a hospitalization in a residential psychiatric treatment center that is authorized by the division for payment for services for a recipient under the age of 21 who has been stabilized and is therefore ready for transition or discharge.

(99) "hearing services" means audiology services of an audiologist, diagnostic hearing testing, hearing therapy, hearing aids and accessories, services of a hearing aid dealer, hearing aid repairs, and hearing aid batteries.

History: Eff. 12/31/92, Register 124; am 5/5/93, Register 126; am 6/5/93, Register 126; am 12/19/93, Register 128; am 2/23/94, Register 129; am 12/24/94, Register 132; am 8/13/95, Register 135; am 1/1/96, Register 136; readopt 8/7/96, Register 139; am 2/1/97, Register 141; am 11/29/97, Register 144; am 6/26/98, Register 146; am 5/5/99, Register 150; am 11/1/2000, Register 156; am 7/11/2002, Register 163; am 3/26/2003, Register 165; am 5/15/2004, Register 170; am 8/19/2004, Register 171; am 4/28/2005, Register 174

Authority: AS 47.05.010

AS 47.07.030

AS 47.07.040

Editor's note: The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, dated 2000 and adopted by reference in 7 AAC 43.1990, may be obtained from the American Medical Association at (800) 621-8335; from American Psychiatric Publishing, Inc., 1000 Wilson Boulevard, Suite 1825, Arlington, Virginia 22209-3901, telephone (703) 907-7322 or (800) 368-5777; or from the American Psychiatric Association at the following electronic mail address: appi@psych.org. This manual is also available for inspection at the Department of Health and Social Services, Division of Health Care Services, 4501 Business Park Boulevard, Suite 24, Anchorage, Alaska 99503-7167.

This section is substantially similar to the emergency regulation 7 AAC 43.730 that took effect August 6, 1992, Register 123 (October 1992). That section, however, was not made permanent and the substantive provisions of it were moved to this section. As of Register 126 (July 1993), the contents of 7 AAC 43.990 were combined with former 7 AAC 43.090. The history line of former 7 AAC 43.090 was not incorporated into the 7 AAC 43.990 history line. Effective March 26, 1993, amendments to the definition of "psychiatric facility" and a new definition of "residential psychiatric treatment center" were adopted as emergency amendments to former 7 AAC 43.090. Those regulations were amended and made permanent on 6/5/93, as shown in 7 AAC 43.990 as of Register 126 (July 1993).

As of Register 126 (July 1993), definitions of "inpatient psychiatric hospital facility," "inpatient psychiatric services," "inpatient interdisciplinary team," and "professional review organization," originally adopted in 7 AAC 43.580 as emergency regulations on January 1, 1993 and amended March 26, 1993, were moved to 7 AAC 43.990 and renumbered.

Before Register 128 (January 1994), the substance of 7 AAC 43.1990 was contained in 7 AAC 43.990. The history for 7 AAC 43.1990 reflects the history of the section under its former number.

As of Register 132 (January 1995), the definitions in this section have been reorganized to put them in alphabetical order, regardless of when each of them was adopted.

Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.1990 in its entirety, without change, under AS 47.05 and AS 47.07. Executive Order No. 72 transferred certain rate-setting authority to the department.