Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 135 - Medicaid Coverage; Behavioral Health Services
Article 1 - Scope; Eligibility; Enrollment; Authorization
7 AAC 135.055 - Adult experiencing a serious mental illness

Universal Citation: 7 AK Admin Code 135.055

Current through November 28, 2024

(a) An adult experiencing a serious mental illness is an individual 21 years of age or older who currently has or at any time during the past year has had a diagnosable mental, emotional, or behavioral disorder of sufficient duration to meet diagnostic criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, adopted by reference in 7 AAC 160.900, or the International Classification of Diseases, adopted by reference in 7 AAC 160.900, and that

(1) has consistently resulted in
(A) impaired thinking and judgment that may include the presence of delusions or hallucinations;

(B) socially disruptive behavior that may include an emotional response that is inappropriate to the situation; or

(C) conduct that is illegal or outside socially accepted rules and mores;

(2) has resulted in serious functional impairment that interferes with the individual's ability to participate in two or more of the following life domains within a culturally appropriate context:
(A) the ability to fulfill social responsibilities, including the ability to engage in work, school, parenting, maintaining a household, or other meaningful, productive activity;

(B) the ability to meaningfully interact with others, including the ability to actively communicate with others, maintain a supportive social network, avoid isolation, and control disruptive behaviors;

(C) the capacity for self-care of the individual's physical health, personal hygiene and grooming, and nutritional needs;

(D) the capacity to maintain mental health, including the ability to problem-solve issues, to maintain the individual's independence and personal safety, and to use available community resources for those purposes; or

(3) has resulted in current hospitalization or the imminent risk of hospitalization.

(b) In addition to the impairments described in (a)(1) and (2) of this section, for individuals with cognitive impairments or organic brain syndrome, there must be documented evidence showing the ability of the individual to benefit from rehabilitative services that would enable the individual to self-regulate behavior, modulate emotional reactivity, and improve functioning in major Life domains.

Authority:AS 47.05.010

AS 47.07.030

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