Mental Health Targeted Case Management Sample Clauses

Mental Health Targeted Case Management. Services designed to assist Enrollees with gaining access to needed medical, social, educational, and other services and supports. Enrollees are eligible to receive these services based on the Adult Needs Strengths Assessment (ANSA) tool and other diagnostic criteria used to establish medical necessity.
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Mental 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 Mental Health Targeted Case Management Coverage and Limitations Handbook. The Health Plan may accept a provider’s mental health targeted case management certification program if it was approved by the Agency or another health plan. The Health Plan shall maintain documentation of such approval and provider certification. (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 Mental Health 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. 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; WellCare of Florida, Inc., Medicaid HMO Non-Reform Contract (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 Mental Health Targeted Case Management Coverage and Limitations Handbook. (2) The Health Plan also shall have case...
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Mental Health Targeted Case Management a. The PSN must provide targeted Case Management services to Children/Adolescents with serious emotional disturbances and adults with a severe mental illness as defined below. The PSN shall meet the intent of the services as outlined below and in the Medicaid Mental Health Targeted Case Management Coverage and Limitations Handbook. The PSN 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. 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.
Sample 1
Mental Health Targeted Case Management. 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. 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.
Sample 1

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