On December 2, 2008, the Centers for Medicare and Medicaid Services (CMS) approved a State Plan Amendment (SPA) for Targeted Case Management (TCM) which funds Intensive Care Coordination services. Click here to review the approved TCM SPA.
On June 4, 2009, CMS approved a State Plan Amendment for EPSDT services which funds all of the remaining home-based services, except crisis stabilizaton services. A separate SPA for this service is pending.
The covered services include:
- Intensive care coordination involves a single care coordinator, a single treatment team, and a single treatment plan that guide the provision of all mental health and related support services.
- A comprehensive home-based assessment includes an in-depth review of past records and treatment, a home visit, multiple interviews with family members, teacher and other collaterals, and leads to a strength-based assessment of the child and his or her needs.
- Family Training and Support helps families participate in the wraparound planning process, access services, and navigate child-serving agencies.
- Mobile crisis intervention and stabilization will be available 24/7 to provide short-term emergency care in the home to evaluate and treat a child in crisis, without the necessity to go to an emergency room or medical facility.
- Crisis stabilization provides staff and treatment in the home or another community setting for up to seven days.
- In-home behavioral services address challenging behaviors in the home and community. A behavioral therapist writes and monitors a behavioral management plan with the family, while a behavioral aide works with the family to implement the plan in the home and in the community.
- In-home therapy services address social or emotional issues. A mental health therapist provides counseling and therapy to the child and family. The therapist may be assisted by an aide who provides support the child in the home, school or community/recreational settings.
- Therapeutic Mentoring helps a child develop independent living, social and communication skills, as well as providing education, training and support services for children and their families.
For the eligibility criteria for each service, see the medical necessity criteria for mobile crisis intervention, crisis stabilization, intensive care coordination, family partners, in-home behavior, in-home therapy, and therapeutic mentoring.
For a detailed description of each service, see the service specifications for mobile crisis intervention, crisis stabilization, intensive care coordination, family partners, in-home behavior, in-home therapy, and therapeutic mentoring.