Eligibility
Criteria

To access both programs each individual needs to meet DMAS guidelines 


To be eligible for Mental Health Skill-Building Services, a client must meet all the following:


·        Have a need for individualized training in acquiring basic living skills such as symptom management; adherence to psychiatric and medication treatment plans; development and appropriate use of social skills and personal support system; personal hygiene; food preparation; or money management.

·        Have a qualifying mental health diagnosis (Psychotic disorder, major depressive disorder-recurrent, or bipolar disorder I or II).  If an individual has another disorder (such as, but not limited to PTSD and anxiety disorders) they may meet eligibility requirements if a physician determines it is a significant mental illness that results in severe and recurrent disability that produces functional limitations in major life activities, and the individual requires individualized training to achieve or maintain independent living in the community (this must be documented by a physician);

·        Have a prior history of qualifying mental health treatment (psychiatric hospitalization, residential treatment, residential crisis stabilization, PACT or ICT services, RTC-Level C placement, or TDO evaluation by a CSB/BHA due to mental health decompensation).  This bullet must be met to be initially admitted to services, however not for subsequent authorizations;

·        Have had a prescription for an anti-psychotic, mood stabilizing, or anti-depressant medication within the twelve months prior to the assessment date unless a physician documents that such medication is medically contraindicated.  This bullet must be met to be initially admitted to services, however not for subsequent authorizations; and

·        If an individual is under the age of 21, they must be in an independent living situation or transferring into one within six months.

To be eligible for Psychosocial Rehabilitation Services, a client must meet all of the following:


Individuals must demonstrate a clinical need for services arising from a condition due to mental, behavioral, or emotional illness, which results in significant functional impairment in major life activities.  Services are provided to individual who without these services would be unable to remain in the community OR who meet at least two of the following criteria on a continuing or intermittent basis:


·        Have trouble in establishing or maintaining normal interpersonal relationships to such a degree that they are at risk of psychiatric hospitalization, homelessness, or isolation from social supports;

·        Have trouble in activities of daily living such as maintaining personal hygiene, preparing food and maintaining adequate nutrition, or managing finances to such a degree that health or safety is jeopardized.

·        Exhibit such inappropriate behavior that repeated interventions by the mental health, social services, or judicial system are necessary or

·        Exhibit difficulty in cognitive ability such that they are unable to recognize personal danger or significantly inappropriate social behavior.


To receive Psychosocial Rehabilitative Services, the individual must also meet one of the following criteria listed below:


1.     Have experienced long-term or repeated psychiatric hospitalization; or

2.     Have trouble in activities of daily living, and interpersonal skills or

3.     Have a limited or non-existent support system; or

4.     Are unable to function in the community without intensive intervention; or

5.     Require long-term services to be maintained in the community.