Integrative Healthcare Services

An evaluation of the beneficiary for the presence of a mental illness. This assessment includes a comprehensive bio-psychosocial interview and review of relevant psychological, medical, and educational records, clinical interviews with the beneficiary, family members or guardians as appropriate, review of the presenting problems, symptoms and functional deficits, strengths, medical and educational records and history, including past psychological assessment report and records.

Planned face-to-face interventions intended to help the beneficiary achieve and maintain stability; improve their physical, mental, and emotional health; and cope with or gain control over the symptoms of their illness(es) and the effects of their disabilities.

An interpersonal, relational intervention directed towards increasing an individual’s sense of well-being and reducing subjective discomforting experience. IP may be psychotherapeutic and/or therapeutically supportive in nature. IP involves planned therapeutic interventions that focus on the enhancement of a beneficiary’s capacity to manage his or her emotions and behaviors through effective decision making, developing and acquiring coping skills, making better choices and decisions regarding co-occurring substance abuse, achievement of personal goals, and development of self-confidence and self-esteem.

The therapist assists family members in developing a greater understanding of the beneficiary’s psychiatric and/or behavioral disorder and the appropriate treatment for this disorder, identifying maladaptive interaction patterns between family members and how they contribute to the beneficiary’s impaired functioning, and identifying and developing competence in utilizing more adaptive patterns of interaction. FP involves interventions with members of the beneficiary’s family unit (i.e., immediate or extended family or significant others) with or on behalf of a beneficiary to restore, enhance or maintain the family unit.

The group process allows members to offer each other support, share common experiences, identify strategies that have been successful for them, and to challenge each other’s behaviors and cognitions. The therapist guides the group to ensure the process is productive for all members and focuses on identified therapeutic issues .

Telephonic short-term service is to assist a beneficiary who is experiencing urgent or emergent marked deterioration of functioning related to a specific precipitant in restoring his or her level of functioning. Face to Face interventions for the reduction of the immediate personal distress experienced by the beneficiary.

Medication Management involves prescribing and then reviewing medications for their side effects. Medication Monitoring involves observing and encouraging people to take their medications as prescribed (frequently used with people with a poor compliance history). Administration, which is the actual giving of an oral medication by a licensed professional. Training, which educates beneficiaries and their families on how to follow the medication regime and the importance of doing so. Assess the need for beneficiaries to see the Physician.

Independent living skills development related to increasing the beneficiary’s ability to manage his or her illness, illness, to improve his or her quality of life, and to live as actively and independently in the community as possible.

Personal living skills development in the understanding and practice of daily and healthy living habits and self-care skills.

Interpersonal ST that enhances the beneficiary’s communication skills, ability to develop and maintain environmental supports, and ability to develop and maintain interpersonal relationships.

This service is provided to children and adolescents ages 0 to 21. The purpose of this face-to-face service is to provide the beneficiary with in vivo redirection and modeling of appropriate behaviors in order to enhance his or her functioning within the home or community. Shadowing (following and observation) a beneficiary in any setting is not reimbursable under Medicaid.

The goal of B-MOD is to alter patterns of behavior that are inappropriate or undesirable of the child or the adolescent. B-MOD involves the utilization of regularly scheduled interventions designed to optimize emotional and behavioral functioning in the natural environment through the application of clinically planned techniques that promote the development of healthy coping skills, adaptive interactions with others, and appropriate responses to environmental stimuli.

The service is provided to children and adolescents ages 0 to 21. The purpose of this face-to-face service is to enable the family or caregiver (parent, guardian, custodian or persons serving in a caregivers role) to serve as an engaged member of the beneficiary’s treatment team and to develop and/or improve the ability of the family or caregiver(s) to appropriately care for the beneficiary. Family Services is intended to be time-limited, and the intensity of services offered should reflect the scope of impairment. Services are generally more intensive and frequent at the beginning of treatment and are expected to decrease over time as the beneficiary’s and family/caregiver’s skills develop.