Unlike child mental health services, which are mandated under Early and Periodic Screening Detection and Treatment (EPSDT), states have the choice of whether to provide intensive community based services to adults under the Targeted Case Management and Psychiatric Rehabilitative Options. No systematic study of the intensive community-based services furnished by states under this option has been conducted. As more and more states move individuals with mental illness into managed care arrangements, it is increasingly important to understand what services states can include in these contracts.
This study identifies targeted case management and the array of rehabilitative services available for adults on Medicaid in managed care and fee-for-service programs in 28 states with targeted case management and 39 states with psychiatric rehabilitation. This study is the only one to provide a detailed list of rehabilitation services including the following: Assertive Community Treatment, skills training, peer services, crisis intervention services, therapeutic recreation services, management and education, assessment and rehabilitation planning, collateral services, outreach to underserved populations, and substance abuse services.
The study employed a two-part review to identify covered services. First, state Medicaid regulations, provider manuals, state plans, Requests for Proposals, and contracts were examined using a standardized review instrument to identify the Medicaid-covered services. Second, a summary of covered services was sent for review to the state Medicaid agency and the state Mental Health Directors and Commissioners.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. Identify the array of community-based rehabilitative mental health services that can be covered under the Psychiatric Rehabilitative Option in Medicaid. 2. List the most common community-based rehabilitative services for adults covered under Medicaid. 3. Describe differences in services available through fee-for-service and Medicaid programs.
Keywords: Mental Health Care, Medicaid
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.