1. (a) The department will pay a community behavioral health services provider for therapeutic behavioral health services, for a recipient under 21 years of age with a severe behavioral disorder, if those services

   1. (1) improve the recipient's overall functioning and reduce the likelihood of

      1. (A) removal from a school setting;
      2. (B) placement out of the family home; or
      3. (C) referral to institutional care;
   2. (2) help the recipient's family to develop or improve specific child behavior management skills;
   3. (3) promote wellness, recovery, and resiliency;

   4. (4) help the recipient

      1. (A) develop or improve specific age-appropriate social behavior;
      2. (B) develop or improve self-management skills that will support academic success; and
      3. (C) make better behavioral choices within their family, school, and community overall; or
   5. (5) assist the recipient in developing more functional coping strategies.

2. (b) Therapeutic behavioral health services for children may be provided

   1. (1) on the premises of the community behavioral health services provider, the recipient's home, the recipient's school, or any other appropriate community setting;
   2. (2) to an individual, family, or group.

3. (c) Therapeutic behavioral health services for children are limited to the following:

   1. (1) teaching of life skills designed to restore the recipient's functioning;
   2. (2) counseling focused on functional improvement, recovery, and relapse prevention;
   3. (3) encouraging and coaching.
4. (d) Except as provided in (e) of this section, the department will not pay for therapeutic behavioral health services delivered in a classroom setting if those services are delivered by the teacher providing the academic program.

5. (e) The department will pay for therapeutic behavioral health services for children, when provided in a classroom setting, as a group session only if

   1. (1) all group participants have similar treatment needs; and

   2. (2) the individual rendering the services facilitates a group session outside the regular academic class at least twice per week for the purpose of

      1. (A) creating a clear awareness among recipients of the specific in-class behaviors that are the focus of treatment;
      2. (B) reviewing by means of the group process each recipient's strategies for success;
      3. (C) facilitating the group's assessment of individual progress; and
      4. (D) preparing each recipient in the group for the classroom.

(Eff. 10/1/2011, Register 199)

Authority: AS 47.05.010, AS 47.07.030