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<br />d. Services and supplies for <br />that period of time deemed medically neces- <br />sary in a Residential Treatment Center or <br />Crisis Stabilization Unit. Benefits may be <br />used only in situations in which the <br />member has a serious mental illness <br />which substantially impairs the person's <br />thought, perception of reality~ emotional <br />process, or judgment or grossly impairs <br />behavior as manifested by recent disturbed <br />behavior and which would otherwise <br />necessitate confinement in a hospital if <br />such care and treatment were not available <br />through a Crisis Stabilization Unit or <br />Residential Treatment Center for children <br />and adolescents. <br /> <br />20% of <br />Eligible <br />Expenses <br />no t to <br />exceed 60 <br />days maxi- <br />mum per <br />contract <br />year. <br /> <br />The services rendered for which benefits are to be paid must be <br />based on a Treatment Plan. The benefits are subject <br />to the same benefit maximums, durational limits, and copayment <br />factors. <br /> <br />ProvIders of services for which benefits are to be paid must be <br />licensed or operated by the appropriate state agency or board to <br />provide those services. <br /> <br />Treatment in a Resi~ential Center for children and adolescents <br />shall be determined as if T1ecessary care and treatmeT1t in a <br />Residential Treatment Center for children and adolescents were <br />inpatient care and treatment in a hospital, and each two days of <br />treatment in a Residential Treatment Center for children and <br />adolescents will be considered equal to one day of treatment of <br />mental or emotional illness or disorder in a hospital or inpatient <br />program for the purpose of determining policy benefits and benefit <br />maximums. <br /> <br />Treatment provided through Crisis Stabilization Units shall be <br />determined as if necessary care and treatment through Crisis <br />Stabilization Units were inpatient care and treatment in a <br />hospital, and two days in a Crisis Stabilization Unit are <br />considered equal to one day of treatment of mental or emotional <br />Illness or disorder in a hospital or inpatient program for the <br />purpose of determining policy benefits and benefit maximums. <br />Treatment provided through crisis stabilization units shall be <br />reimbursed for facilities licensed or certified by the Texas <br />Department of Mental Health and Mental Retardation. <br /> <br />Crisis Stabilization Unit means a 24 hour residential program that <br />is usually short-term in nature and that provides intensive <br />supervision and highly structured activities to persons who are <br />demonstrating an acute demonstrable psychiatric crisis of moderate <br /> <br />i'1HR ( 1 /88 ) <br /> <br />2 <br />