Behavioral Health Targeted Case Management Sample Clauses

Behavioral Health Targeted Case Management a. The Health Plan must provide targeted Case Management services to Children/Adolescents with serious emotional disturbances and adults with a severe mental illness as defined below. The Health Plan shall meet the intent of the services as outlined below and in the Medicaid Mental Health Targeted Case Management Coverage and Limitations Handbook. The Health Plan shall set criteria and clinical guidelines for Case Management services. Service limits and criteria developed cannot be more restrictive than those in Medicaid policy and as stated below. (1) At a minimum, case management services are to incorporate the principles of a strengths-based approach. Strengths-based case management services are an alternative service modality for working with individuals and families. This method stresses building on the strengths of individuals that can be used to resolve current problems and issues, countering more traditional approaches that focus almost exclusively on individuals’ deficits or needs.
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Behavioral Health Targeted Case Management a. The Health Plan shall provide targeted case management services to children/adolescents with serious emotional disturbances and adults with a severe and persistent mental illness as defined below. The Health Plan shall either develop its own targeted case management certification program or approve a provider training program that meets the criteria in the Medicaid Targeted Case Management Coverage and Limitations Handbook. (1) The Health Plan shall meet the intent of the services and ensure the qualification and certification of providers as outlined below and in the Medicaid Targeted Case Management Coverage and Limitations Handbook. (2) The Health Plan shall set criteria and clinical guidelines for case management services. Service limits and criteria developed cannot be more restrictive than those in Medicaid policy. (3) At a minimum, case management services are to incorporate the principles of a strengths-based approach. Strengths-based case management services are an alternative service modality for working with individuals and families. This method stresses building on the strengths of individuals that can be used to resolve current problems and issues, countering more traditional approaches that focus almost exclusively on individual’s deficits or needs. AMERIGROUP Florida, Inc. d/b/a Medicaid Non-Reform and Reform AMERIGROUP Community Care HMO Contract b. Target Populations (1) Behavioral health targeted case management services shall be available to all enrollees: (a) Who require numerous services from different providers and also require advocacy and coordination to implement or access services; (b) Who would be unable to access or maintain consistent care within the service delivery system without case management services; (c) Who do not possess the strengths, skills, or support system to allow them to access or coordinate services; (d) Who may benefit from case management but lack the skills or knowledge necessary to access services; or (e) Who do not meet these criteria but may still be eligible for limited targeted case management services by meeting exception criteria contained in the Medicaid Targeted Case Management Coverage and Limitations Handbook. (2) The Health Plan also shall have case management services available to children/adolescents who have a serious emotional disturbance, which is: a defined mental disorder; a level of functioning which requires two or more coordinated behavioral health services to be able to live in the ...
Sample 1
Behavioral Health Targeted Case Management a. The Health Plan shall provide targeted case management services to children/adolescents with serious emotional disturbances and adults with a severe and persistent mental illness as defined below. The Health Plan shall either develop its own targeted case management certification program or approve a provider training program that meets the criteria in the Medicaid Targeted Case Management Coverage and Limitations Handbook. HealthEase of Florida, Inc. Medicaid HMO Non-Reform Contract (1) The Health Plan shall meet the intent of the services and ensure the qualification and certification of providers as outlined below and in the Medicaid Targeted Case Management Coverage and Limitations Handbook. (2) The Health Plan shall set criteria and clinical guidelines for case management services. Service limits and criteria developed cannot be more restrictive than those in Medicaid policy. (3) At a minimum, case management services are to incorporate the principles of a strengths-based approach. Strengths-based case management services are an alternative service modality for working with individuals and families. This method stresses building on the strengths of individuals that can be used to resolve current problems and issues, countering more traditional approaches that focus almost exclusively on individual’s deficits or needs.
Sample 1
Behavioral Health Targeted Case Management a. The Health Plan shall provide targeted case management services to children/adolescents with serious emotional disturbances and adults with a severe and persistent mental illness as defined below. The Health Plan shall either develop its own WellCare of Florida, Inc. d/b/a Staywell Health Plan of Florida Medicaid HMO Non-Reform Contract targeted case management certification program or approve a provider training program that meets the criteria in the Medicaid Targeted Case Management Coverage and Limitations Handbook. (1) The Health Plan shall meet the intent of the services and ensure the qualification and certification of providers as outlined below and in the Medicaid Targeted Case Management Coverage and Limitations Handbook. (2) The Health Plan shall set criteria and clinical guidelines for case management services. Service limits and criteria developed cannot be more restrictive than those in Medicaid policy. (3) At a minimum, case management services are to incorporate the principles of a strengths-based approach. Strengths-based case management services are an alternative service modality for working with individuals and families. This method stresses building on the strengths of individuals that can be used to resolve current problems and issues, countering more traditional approaches that focus almost exclusively on individual’s deficits or needs.
Sample 1

Related to Behavioral Health Targeted Case Management

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