Medicaid Manual, Index to Chapter III

108 E. Main St., Milan, MI 48160 Phone: (734) 439-4055. Fax: 439-4056

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TABLE OF CONTENTS, CHAPTER III
MEDICAID MANUAL

Summary of contents:

1 - 10 General administrative information
11-17 Covered Services, DD and MI
18-22 Alternative Covered Services, DD and MI
23-25 Home Based Services
26-29 ACT (Assertive Community Treatment)
30-33 Clubhouse
34-37 Crisis Residential Services
38-42 Case Management
43-44 Personal Care in Licensed Residential
45-49 Inpatient Psych Hospital Admissions
50-54 Other hospitalization issues, crisis stabilization
55-61 Covered Services for DD
62-72 Hab Waiver for DD
73-79 Children’s Waiver, Fee for Service
80 Medicare, Fee for Service, children’s waiver
81 Series billing, fee for service, children's waiver
82 MI and concurrent substance abuse disorders
83 School-based services

DETAILED TABLE OF CONTENTS:

GENERAL INFORMATION

1	CHAPTER CONTENTS CRITERIA FOR APPROVAL
2	Comprehensive Array of Services Provider Assurances
3	Standards Administrative Organization Fiscal Management
4	Administrative Housekeeping
5	Clinical Recordkeeping Health Care Coordination Interagency Collaboration
6	Staffing PROVIDER CERTIFICATION AND ENROLLMENT
7	PROGRAM REQUIREMENTS
8	(Continued)
9	LOCATION OF SERVICES DAY PROGRAMS
10	Continued

COVERED SERVICES
(For Mentally Ill, Developmentally Disabled, and
Substance Abuse consumers)

11	GENERAL INFORMATION APPLIED BEHAVIORAL SERVICES ASSERTIVE COMMUNITY TREATMENT ASSESSMENTS Health Assessment
12	Psychiatric Evaluation Psychological testing All Other Assessments and Testing CASE MANAGEMENT CHILD THERAPY
13	CRISIS INTERVENTION CRISIS RESIDENTIAL SERVICES ENHANCED HEALTH SERVICES FAMILY THERAPY
14	INDIVIDUAL/GROUP THERAPY INTENSIVE CRISIS STABILIZATION SERVICES MEDICATION ADMINISTRATION MEDICATION REVIEW
15	MENTAL HEALTH HOME-BASED SERVICES NURSING HOME MENTAL HEALTH MONITORING OCCUPATIONAL THERAPY Evaluation Therapy
16	PERSONAL CARE IN SPECIALIZED SETTINGS PHYSICAL THERAPY Evaluation Therapy
17	PSYCHOSOCIAL REHABILIATION/CLUBHOUSE PROGRAMS SPEECH, HEARING, AND LANGUAGE Evaluation TREATMENT PLANNING TRANSPORTATION

ALTERNATIVE COVERED SERVICES
(For Mentally Ill, Developmentally Disabled, and
Substance Abuse consumers)

18	GENERAL INFORMATION COMMUNITY INCLUSION AND INTEGRATION SERVICES Community Living Training and Supports
19	Skill Building Assistance CRISIS RESPONSE: EXTENDED OBSERVATION BEDS FAMILY SUPPORT SERVICES
20	Family Skills Development Respite Care HOUSING ASSISTANCE
21	PEER-OPERATED SUPPORT SERVICES PREVENTION AND CONSULTATION SERVICES SPECIALIZED BEHAVIORAL HEALTH (WRAP AROUND) CHILDREN AND ADOLESCENTS
22	ADDITIONAL CMH RESPONSIBILITIES

HOME-BASED SERVICES

23	General information Program approval
24	ORGANIZATIONAL STRUCTURE QUALIFIED STAFF
25	FAMILY FOCUSED PLAN OF SERVICE SCOPE OF SERVICE LOCATION OF SERVICE

ASSERTIVE COMMUNITY
TREATMENT PROGRAM (ACT)

26	GENERAL INFORMATION ENROLLMENT TARGET POPULATION
27	ELEMENTS OF ACT Team Based Service Delivery Team Composition
28	Primary Provider and Facilitator of Service Availability of Services Highly Individualized Services
29	Settings Services

PSYCHOSOCIAL REHABILITATION
/CLUBHOUSE PROGRAMS

30	PROGRAM APPROVAL TARGET POPULATION ESSENTIAL ELEMENTS Member Choice/Involvement
31	Informal Setting Program Structure and Services ORDERED DAY
32	Symptom Identification and Care Competency Building Environmental Support
33	VOCATIONAL AND EDUCATIONAL SERVICES SOCIAL OPPORTUNITIES MEMBER AND STAFF CAPACITY

CRISIS RESIDENTIAL SERVICES

34	GENERAL INFORMATION POPULATION COVERED SERVICES Children - Crisis Residential Services
35	Adult - Crisis Residential Services PROVIDER CRITERIA QUALIFIED STAFF LOCATION OF SERVICES
36	ADMISSION CRITERIA DURATION OF SERVICES INDIVIDUAL PLAN OF SERVICE
37	(Continued)

CASE MANAGEMENT

38	GENERAL INFORMATION
39	CORE ELEMENTS OF CASE MANAGEMENT Assessment Service Plan Development
40	Linking/Coordination of Services Monitoring of Services
41	QUALIFICATIONS OF PROVIDERS QUALIFICATIONS OF PRIMARY CASE MANAGERS
42	FREEDOM OF CHOICE

PERSONAL CARE IN LICENSED
SPECIALIZED RESIDENTIAL SETTINGS

43	GENERAL INFORMATION SERVICES PROVIDERS
44	DOCUMENTATION

INPATIENT PSYCHIATRIC
HOSPITAL ADMISSIONS

45	GENERAL INFORMATION ADMISSIONS Clients Under Age 21
46	Emergency Room Services
47	Form to fill out for inpatient hospitalization
48	Back side of form to fill out
49	PAYMENTS TO HOSPITALS INPATIENT PSYCHIATRIC ADMISSIONS TO OUT-OF-STATE NONBORDERLAND HOSPITALS CMHSP RESPONSIBILITIES

OUTPATIENT PARTIAL HOSPITALIZATION

50	GENERAL INFORMATION

SPECIAL SITUATIONS TO HOSPITALIZATIONS

51	Patients who have other insurance Clients who did not have Medicaid eligibility upon admission

INTENSIVE CRISIS STABILIZATION

52	GENERAL INFORMATION POPULATION SERVICES QUALIFIED STAFF
53	LOCATION OF SERVICES INDIVIDUAL PLAN OF SERVICE
54	(Continued)

COVERED SERVICES AND SUPPORTS FOR
PERSONS WITH DEVELOPMENTAL DISABILITIES

55	GENERAL INFORMATION CRISIS STABILIZATION AND RESPONSE
56	ASSESSMENT AND EVALUATION SUPPORT AND SERVICE COORDINATION
57	PREVENTION AND CONSULTATION SERVICES COMMUNITY LIVING SUPPORTS Supports Staff
58	Assistive Technology Environmental Modifications Housing Assistance
59	Skill Building Assistance Family Support Services
60	Other Services
61	Other Services (continued)

HABILITATION/SUPPORTS WAIVER FOR
PERSONS WITH DEVELOPMENTAL DISABILITIES

62	GENERAL INFORMATION SUPPORTS AND SERVICES Chore Services
63	Community Living Supports
64	Enhanced Dental Enhanced Medical Equipment and Supplies
65	Enhanced Pharmacy Environmental Modifications
66	(Continued)
67	Family Training Habilitation Education Services Out-of-Home Non-vocational Habilitation
68	Personal Emergency Response Systems (PERS) Prevocational Services
69	Private Duty Nursing Respite Care
70	Supports Coordination
71	Supported Employment
72	SUPPORTS AND SERVICE PROVIDER QUALIFICATIONS

CHILDREN’S WAIVER
FEE FOR SERVICE

73	GENERAL INFORMATION ASSESSMENTS Health Assessment Psychiatric Evaluation
74	Psychological Testing All Other Assessments and Testing BEHAVIOR MANAGEMENT REVIEW CASE MANAGEMENT
75	CHILD THERAPY CRISIS INTERVENTION FAMILY THERAPY
76	HEALTH SERVICES INDIVIDUAL THERAPY MEDICATION ADMINISTRATION MEDICATION REVIEW OCCUPATIONAL THERAPY Evaluation
77	Therapy PHYSICAL THERAPY Evaluation Therapy PROFESSIONAL TREATMENT MONITORING
78	PERIODIC REVIEW OF TREATMENT SPEECH, HEARING, AND LANGUAGE Evaluation Therapy
79	TREATMENT PLANNING

MEDICARE: FEE FOR SERVICE - CHILDREN’S WAIVER

80	GENERAL INFORMATION

SERIES BILLING:
FEE FOR SERVICE - CHILDREN’S WAIVER

81	GENERAL INFORMATION

MENTAL HEALTH AND CONCURRENT
SUBSTANCE ABUSE DISORDERS

82	GENERAL INFORMATION

MENTAL HEALTH AND
SCHOOL-BASED SERVICES

83	GENERAL INFORMATION

[To get your own copy of the Medicaid Manual, click on GETBOOK.]

[To read the Contract between the CMH offices and the Department of Community Health, click on CONTRACT.]

[For the Best Practice Guidelines, which tells more about what a CMH office is required to do, click on BPG.]

[How to get what you need from CMH, click on HOW.]

[What Medicaid pays for, click on PAYS.]

Home       About Martha
  Developmental Disabilities           Social Security
Milan, Michigan

Martha A. Churchill, Attorney
108 E. Main St., Milan, MI 48160
Phone: (734) 439-4055. Fax: 439-4056 Send e-mail

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