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(C) that is not required to operate under the direction of a physician and does not provide behavioral health clinic services;

(21) “dual diagnosis enhanced program” means a program that

(A) has a higher level of integration of substance use and mental health treatment services than a dual diagnosis capable program and is able to provide unified treatment of the symptoms of the recipient’s substance use and mental health disorders, in addition to addressing the interactions between the co-occurring disorders; and

(B) provides behavioral health clinic services under the direction of a physician with individual services supervised by a mental health professional clinician;

(22) “functional impairment”

(A) means a disorder that substantially interferes with or prevents a recipient from achieving or maintaining one or more developmentally appropriate social, behavioral, cognitive, communicative, or adaptive skills;

(B) includes disorders of episodic, recurrent, or continuous duration;

(C) does not include temporary, expected responses to stressful events in the recipient’s environment;

(23) “general acute care hospital” has the meaning given in 7 AAC 12.990;

(24) “general direction” means, in a community behavioral health services provider, a physician provides general program and clinical consultative services when needed;

(25) “management of a recipient’s chronic disease” means using a community-wide, systematic, and structured multidisciplinary approach to interventions designed to prevent or manage one or more chronic conditions;

(26) “medication administration services” means the administration, by medical personnel, of injectable or oral medications to a recipient, documentation of medication compliance, assessment and documentation of side effects, and evaluation and documentation regarding the effectiveness of the medication; in this paragraph, “medical personnel” means

(A) a physician;

(B) a physician assistant;

(C) an advanced practice registered nurse;

(D) a registered nurse supervised by a physician or advanced practice registered nurse;

(E) a licensed practical nurse supervised by a physician or advanced practice registered nurse;