1. (a) An adult shall be eligible for community mental health services if he or she has a severe mental illness (SMI) pursuant to (b) below.

2. (b) An adult shall be determined by a CMHP to have a severe mental illness (SMI) if he or she meets each of the following criteria:

   1. (1) The adult has one of the following:

      1. a. A diagnosis of mental illness; or
      2. b. A provisional diagnosis of mental illness, if the person has not previously applied for community mental health services;

   2. (2) The adult has a severe functional impairment as a result of his or her mental illness as determined through assessment of the person's abilities in the following functional domains:

      1. a. Activities of daily living;
      2. b. Interpersonal functioning;
      3. c. Adaptation to change; and
      4. d. Concentration and task performance or pace; or
      5. e. Equivalent domains as defined in an outcome measurement tool approved by the commissioner;

   3. (3) For adults age 18-59, the assessment of functional impairment required by (2) above demonstrates:

      1. a. Moderate impairment causing chronic or durable problems in each of the four functional domains such that the person requires regular support and a variety of services;
      2. b. Marked impairment causing ongoing symptoms in two or more of the functional domains such that the person requires intensive and frequent supportive interventions;
      3. c. Extreme impairment causing risk of death in at least one functional domain such that the person requires a constant level of services; or
      4. d. Equivalent impairment ratings based on an outcome measurement tool approved by the commissioner; and

   4. (4) The assessment of functional impairment of adults age 60 and older demonstrates, without regard to the older adult’s score on the General Assessment of Functioning (GAF) scale:

      1. a. Moderate impairment causing chronic or durable problems in three or more of the functional domains; or
      2. b. Marked impairment causing ongoing symptoms that require intensive and frequent supportive interventions in one or more of the functional domains; and
   5. (5) The adult has had the severe functional impairment for less than one year.
3. (c) Redetermination of eligibility in this category shall occur every 2 years.

Source. (See Revision Note at part heading for He-M 401) #4194, eff 1-1-87; ss by #4197 EMERGENCY, eff 12-31-86; ss by #4237, eff 2-27-87, EXPIRED: 2-27-93 New. #6644, eff 12-2-97; ss by #8155, eff 9-2-04, EXPIRED: 9-2-12 New. #10256, INTERIM, eff 1-24-13, EXPIRES: 7-23-13; ss by #10383, eff 7-23-13