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Indiana Administrative Code (Last Updated: December 20, 2016) |
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Title 405. OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES |
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Article 405IAC5. MEDICAID SERVICES |
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Rule 405IAC5-21.6. Adult Mental Health Habilitation Services Program |
Section 405IAC5-21.6-5. Eligibility period; renewal
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(a) A member who is approved to receive AMHH services under this rule shall be eligible for such services for up to a twelve (12) month period, as long as eligibility and needs-based criteria continue to be met.
(b) A reevaluation will be conducted at least every twelve (12) months and shall include the following:
(1) A face-to-face holistic clinical and biopsychosocial evaluation completed by an office-approved AMHH service provider.
(2) Administration of the office-approved behavioral assessment tool to determine whether the member still meets the level of need for intensive community-based services, as demonstrated by a rating level of four (4) or higher.
(3) Assessment of the member's progress towards meeting treatment goals on the IICP.
(4) Documentation that the member continues to meet AMHH financial, target group eligibility, and needs-based criteria.
(5) An updated referral application.
(6) An updated IICP documenting the member's choice of AMHH service or services and AMHH service providers.
(c) The state evaluation team will review and assess the renewal application and reevaluation results to determine whether the member continues to meet AMHH eligibility.
(d) Any approval or denial of eligibility and services under this rule will be communicated to the:
(1) applicant or the applicant's authorized representative; and
(2) referring provider agency.
(Office of the Secretary of Family and Social Services; 405 IAC 5-21.6-5; filed Dec 16, 2013, 9:11 a.m.: 20140115-IR-405130183FRA; filed Aug 1, 2016, 3:44 p.m.: 20160831-IR-405150418FRA)