Current through September 21, 2024
(a) Except as
otherwise specified in Wyoming Medicaid Rules Chapter 1, or as defined herein,
the terminology used in this Chapter is the standard terminology and has the
standard meaning used in behavioral health care, Medicaid, and
Medicare.
(b) "Applied Behavior
Analysis (ABA) Treatment" means behavior analysis services provided to children
between the ages of 0-20 years of age with a diagnosis of Autism Spectrum
Disorder in order to improve social, communication, and learning
skills.
(c) "Behavior analysis"
means the design, implementation and evaluation of the instructional and
environmental modifications based on scientific research and direct and
indirect observation and measurement of behavior and environment to produce
socially significant improvements in human behavior. It includes the empirical
identification of functional relations between behavior and environmental
factors. It does not include psychotherapy, cognitive therapy, psychoanalysis,
hypnotherapy, counseling, psychological testing, personality, intellectual or
neuropsychological assessments or the diagnosis of psychological
disorders.
(d) "Certified center"
means a community mental health or substance abuse treatment center that is
certified by the Wyoming Department of Health, Division of Behavioral
Health.
(e) "Clinical Professional"
means an individual who is licensed as a:
(i)
Licensed Addictions Therapist;
(ii)
Licensed Advanced Practitioner of Nursing with a specialty area of
psychiatric/mental health (APRN);
(iii) Licensed Clinical Social
Worker;
(iv) Licensed Marriage and
Family Therapist;
(v) Licensed
Physician;
(vi) Licensed
Professional Counselor;
(vii)
Licensed Psychiatric Nurse (Master level);
(viii) Licensed Psychologist;
(ix) Licensed Board Certified Behavior
Analyst - Doctoral (BCBA-D), as defined by the Behavior Analyst Certification
Board and the Wyoming Board of Psychology (W.S.
33-27-124 and
33-27-125); or
(x) Licensed Board Certified Behavior Analyst
(BCBA), as defined by the Behavior Analyst Certification Board and the Wyoming
Board of Psychology (W.S. 33-27-124 and
33-27-125).
(f) "Clinical staff" means an individual who
is a:
(i) Case Manager, who has achieved a
bachelor's degree in a human relations discipline, is trained in case
management, and who is working under the documented, scheduled supervision of a
licensed mental health professional;
(ii) Certified Addictions Practitioner (CAP),
who is certified by the Mental Health Professions Licensing Board pursuant to
the Wyoming Mental Health Professions Practice Act (W.S. §§
33-38-101 -113) to practice under
the supervision of a licensed and qualified clinical supervisor;
(iii) Certified Addictions Practitioner
Assistant (CAPA), who is certified by the Wyoming Mental Health Professions
Licensing Board or similar authority in another State to practice under the
supervision of a licensed and qualified clinical supervisor;
(iv) Certified Mental Health Worker (CMHW),
who has achieved a bachelor's degree in a human relations discipline as
specified in the Wyoming Mental Health Professions Licensing Board, Chapter
5-Certified Mental Health Worker and who is working under the documented,
scheduled supervision of a licensed mental health professional;
(v) Certified Peer Specialist (CPS), who has
a minimum general equivalency diploma (GED) or high school diploma; meets the
criteria and supervision requirements of a Mental Health Technician; is
certified by the Division of Behavioral Health as a peer specialist; and is
working under the documented, scheduled supervision of a licensed mental health
professional;
(vi) Certified Social
Worker (CSW) or a Certified Mental Health Worker (CMHW), who is certified by
the Wyoming Mental Health Professions Licensing Board or similar authority in
another State to practice under the supervision of a qualified clinical
supervisor licensed in the state of Wyoming;
(vii) Licensed Board Certified Assistant
Behavior Analyst (BCaBA), as defined by the Behavior Analyst Certification
Board and the Wyoming Board of Psychology (W.S.
33-27-124 and
33-27-125); or
(viii) Licensed Practical Nurse (LPN), who is
performing nursing duties within the scope of practice as defined by the
Wyoming Board of Nursing Rules, Chapter 3-Standards of Nursing
Practice;
(ix) Mental Health
Technician (MHT), who has at minimum a GED or high school diploma, and who is
working under the documented, scheduled supervision of a licensed mental health
professional;
(x) Provisional
Licensee, who is provisionally licensed by the Wyoming Mental Health
Professions Licensing Board or similar authority in another state to practice
under the supervision of a licensed and qualified clinical supervisor. This
includes student interns who meet the qualifications required by their
respective Board and are practicing and billing under the direct supervision of
a licensed and designated qualified clinical supervisor;
(xi) Registered Behavior Technician (RBT),
who has at minimum a GED or high school diploma, is registered with the
Behavior Analyst Certification Board and is a paraprofessional in behavior
analysis who practices under the close, ongoing supervision of a licensed BCBA
or licensed BCaBA and who delivers services that may be assigned to an RBT but
shall not include designing assessment or intervention plans or
procedures;
(xii) Registered Nurse
(RN) who is performing nursing duties within the scope of practice as defined
by the Wyoming Board of Nursing Rules, Chapter 3-Standards of Nursing
Practice;
(g)
"Collateral contact" means an individual involved in the client's care. This
individual may be a family member, guardian, healthcare professional, or person
who is a knowledgeable source of information about the client's situation and
serves to support or corroborate information provided by the client. The
individual contributes a direct and exclusive benefit for the covered
client.
(h) "Habilitative services"
means services that help clients keep, learn, or improve skills and functioning
for daily living. Examples would include therapy for a child who is not walking
or talking at the expected age.
(i)
"Rehabilitative services" means services that help clients keep, get back, or
improve skills and functioning for daily living that have been lost or impaired
because the client was sick, hurt, or suddenly disabled.
