The contracted treatment agencies in our network provide services for adults, adolescents and families who need care for behavioral health problems relating to co-occurring disorders, HIV+, homelessness, intravenous users, legal involvement, pregnancy, and women or men with dependent children. The service descriptions detail the availability of multiple and diverse services to guarantee a continuum of care for the consumer.
SERVICES WE FUND
Aftercare services, including but not limited to relapse prevention, are a vital part of recovery in every treatment level. Aftercare activities include client participation in daily activity functions that were adversely affected by mental illness and/or substance abuse impairments. New directional goals such as vocational education or re-building relationships are often priorities. Relapse prevention issues are key in assisting the client’s recognition of triggers and warning signs of regression. Aftercare services help families and pro-social support systems reinforce a healthy living environment.
Assessment services assess, evaluate, and provide assistance to individuals and families to determine level of care, motivation, and the need for services and supports to assist individuals and families identify their strengths.
Case management services consist of activities aimed at identifying the recipient’s needs, planning services, linking the service system with the person, coordinating the various system components, monitoring service delivery, and evaluating the effect of the services received.
These acute care services, twenty-four (24) hours per day, seven (7) days per week basis, provide brief, intensive mental health residential treatment services. These services meet the needs of individuals who are experiencing an acute crisis and who, in the absence of a suitable alternative, would require hospitalization.
These non-residential care services are generally available twenty-four (24) hours per day, seven (7) days per week, or some other specific time period, to intervene in a crisis or provide emergency care. Examples include: mobile crisis, crisis support, crisis/emergency screening, crisis telephone, and emergency walk-in.
Day Treatment services provide a structured schedule of non-residential services for four (4) or more consecutive hours per day. Activities for children and adult mental health programs are designed to assist individuals to attain skills and behaviors needed to function successfully in living, learning, work, and social environments. Generally, a person receives three (3) or more services a week. Activities for substance abuse programs emphasize rehabilitation, treatment, and education services, using multidisciplinary teams to provide integrated programs of academic, therapeutic, and family services.
These centers are intended to provide a range of opportunities for persons with severe and persistent mental illness to independently develop, operate, and participate in social, recreational, and networking activities.
These non-residential care services are available twenty-four (24) hours per day, seven (7) days per week, and include community-based treatment, rehabilitation, and support services provided by a multidisciplinary team to persons with severe and persistent mental illness.
This cost center provides for incidental expenses, such as clothing, medical care, educational needs, developmental services, FACT Team housing subsidies and pharmaceuticals (if not required by the RFP to be reimbursed through a separate cost reimbursement contract), and other approved costs. All incidental expenses must have prior written authorization by the Department’s authorized staff member or be authorized in the contract.
These services maintain information about resources in the community, link people who need assistance with appropriate service providers, and provide information about agencies and organizations that offer services. The information and referral process involves: being readily available for contact by the individual; assisting the individual with determining which resources are needed; providing referral to appropriate resources; and following up to ensure the individual’s needs have been met, if the individual agrees to such follow-up activities.
Therapeutic services and supports are rendered in non-provider settings such as nursing homes, alternative living facilities (ALF), residences, school, detention centers, commitment settings, foster homes, and other community settings.
Inpatient services are provided in hospitals, licensed under Chapter 395, Florida Statutes, as general hospitals and psychiatric specialty hospitals. They are designed to provide intensive treatment to persons exhibiting violent behaviors, suicidal behaviors, and other severe disturbances due to substance abuse or mental illness.
Intensive Case management services consist of activities aimed at assessing recipient needs, planning services, linking the service system to a recipient, coordinating the various system components, monitoring service delivery, and evaluating the effect of services received. These services are typically offered to persons who are being discharged from a hospital or crisis stabilization unit who are in need of more professional care and who will have contingency needs to remain in a less restrictive setting.
Intervention services focus on reducing risk factors generally associated with the progression of substance abuse and mental health problems. Intervention is accomplished through early identification of persons at risk, performing basic individual assessments, and providing supportive services, which emphasize short-term counseling and referral. These services are targeted toward individuals and families.
Medical services provide primary medical care, therapy, and medication administration to improve the functioning or prevent further deterioration of persons with mental health or substance abuse problems. Included is psychiatric mental status assessment. For adults with mental illness, medical services are usually provided on a regular schedule, with arrangements for non-scheduled visits during times of increased stress or crisis. This service includes medication administration of psychotropic drugs, and other new medications, and psychiatric services.
This Covered Service provides for the delivery of medications for the treatment of substance use or abuse disorders which are prescribed by a licensed health care professional. Services must be based upon a clinical assessment and provided in conjunction with substance abuse treatment.
Structured, community-based services designed to strengthen and/or regain the client’s interpersonal skills, provide psycho-social therapy toward rehabilitation, develop the environmental supports necessary to help the client thrive in the community and meet employment and other life goals and promote recovery from mental illness. Services are typically provided in a community-based program with trained staff and members working as teams to address the client’s life goals and to perform the tasks necessary for the operations of the program. The emphasis is on a holistic approach focusing on the client’s strengths and abilities while challenging the client to pursue those life goals. This service would include, but not be limited to, clubhouses certified under the International Center for Clubhouse Development.
Outpatient services provide a therapeutic environment, which is designed to improve the functioning or prevent further deterioration of persons with mental health and/or substance abuse problems. These services are usually provided on a regularly scheduled basis by appointment, with arrangements made for non-scheduled visits during times of increased stress or crisis. Outpatient services may be provided to an individual or in a group setting. The group size limitations applicable to the Medicaid program shall apply to all Outpatient services funded through a state substance abuse and mental health program contract.
Outpatient detoxification services utilize medication or a psychosocial counseling regimen that assists recipients in their efforts to withdraw from the physiological and psychological effects of the abuse of additive substances.
Outreach services are provided through a formal program to both individuals and the community. Community services include education, identification, and linkage with high-risk groups. Outreach services for individuals are designed to: encourage, educate, and engage prospective clients who show an indication of substance abuse and mental health problems or needs. Client enrollment is not included in Outreach services.
Prevention services are those involving strategies that preclude, forestall, or impede the development of substance abuse and mental health problems, and include increasing public awareness through information, education, and alternative-focused activities. These services may be directed either at a Level II prevention target where the client has been identified or at a Level I prevention target where the client is not identifiable.
These licensed services provide a structured, live-in, non-hospital setting with supervision on a twenty-four (24) hour, seven (7) days per week basis. A nurse is on duty in these facilities at all times. For adult mental health, these services include group homes. Group homes are for longer-term residents. These facilities offer nursing supervision provided by, at a minimum, licensed practical nurses on a twenty-four (24) hours a day, seven (7) days per week basis. For children with serious emotional disturbances, Level 1 services are the most intensive and restrictive level of residential therapeutic intervention provided in a non-hospital or non-crisis support unit setting, including residential treatment centers. Medicaid Residential Treatment Centers (MRTC) and Residential Treatment Centers (RTC) are reported under this cost center. On-call medical care must be available for substance abuse programs. Level 1 provides a range of assessment, treatment, rehabilitation, and ancillary services in an intensive therapeutic environment, with an emphasis on treatment, and may include formal school and adult education programs.
Level II facilities are licensed, structured rehabilitation-oriented group facilities that have twenty-four (24) hours per day, seven (7) days per week, supervision. Level II facilities house persons who have significant deficits in independent living skills and need extensive support and supervision. For children with serious emotional disturbances, Level II services are programs specifically designed for the purpose of providing intensive therapeutic behavioral and treatment interventions. Therapeutic Group Home (TGH), Specialized Therapeutic Foster Home (STFH) – Level II and Therapeutic Foster Home (TFH) – Level 2 are reported under this cost center. For substance abuse, Level II services provide a range of assessment, treatment, rehabilitation, and ancillary services in a less intensive therapeutic environment with an emphasis on rehabilitation, and may include formal school and adult educational programs.
These licensed facilities provide twenty-four (24) hours per day, seven (7) days per week supervised residential alternatives to persons who have developed a moderate functional capacity for independent living. For children with serious emotional disturbances, Level III services are specifically designed to provide sparse therapeutic behavioral and treatment interventions. Therapeutic Group Home (TGH), Specialized Therapeutic Foster Home (STFH) – Level I and Therapeutic Foster Home (TFH) – Level 1 are reported under this cost center. For adults with serious mental illness, this cost center consists of supervised apartments. For substance abuse, Level III provides a range of assessment, rehabilitation, treatment and ancillary services on a long-term, continuing care basis where, depending upon the characteristics of the clients served, the emphasis is on rehabilitation or treatment.
This type of facility may have less than twenty-four (24) hours per day, seven (7) days per week on premise supervision. Residential Level IV services are the least intensive level of residential care. It is primarily a support service and, as such, treatment services are not included in this cost center, although such treatment services may be provided as needed through other cost centers. Level IV includes satellite apartments, satellite group homes, and therapeutic foster homes. For children with serious emotional disturbances, Level IV services are the least intensive and restrictive level of residential care provided in group or foster home settings, therapeutic foster homes, and group care. NOTE: Regular therapeutic foster care can be provided either through Residential Level IV “Day of Care: TFH” or by billing in-home/non-provider setting for a child in a foster home.
This cost center solely provides for room and board with supervisions, twenty-four (24) hours per day, seven (7) days per week basis. It corresponds to Residential Level I. This cost center is not applicable for provider facilities which meet the definition of an Institute for Mental Disease (IMD) as defined in the Center for Medicaid Services’ State Medicaid Manual, Section 4, March 1994.
Corresponds to Residential Level II. Same programs, units, and data elements as Room and Board with Supervision Level I.
Corresponds to Residential Level III. Same programs, units, and data elements as Room and Board with Supervision Level I.
These individualized, stabilizing acute and immediately subacute care services provide short and intermediate duration intensive mental health residential and rehabilitative services on a twenty-four (24) hour per day, seven days per week basis. These services must meet the needs of individuals who are experiencing an acute or immediately subacute crisis and who, in the absence of a suitable alternative, would require hospitalization.
Detoxification programs that utilize medical and clinical procedures to assist adults, children, and adolescents with substance abuse problems in their efforts to withdraw from the physiological and psychological effects of substance abuse. Residential detoxification and addiction receiving facilities provide emergency screening, evaluation, short-term stabilization, and treatment in a secure environment. The maximum unit cost rate for a Juvenile Addiction Receiving Facility that is integrated with a Children’s Crisis Stabilization Unit shall be the maximum unit cost rate for the Crisis Stabilization cost center rather than for the Substance Abuse Detoxification cost center.
Supported employment services are community-based employment services in an integrated work setting which provides regular contact with non-disabled co-workers or the public. A job coach provides long-term, ongoing support for as long as it is needed to enable the recipient to maintain employment.
Supported housing/living is an evidence-based approach to assist persons with substance abuse and mental illness in the selection of permanent housing of their choice. These services also provide the necessary services and supports to assure continued successful living in the community and transitioning into the community. For children with mental health problems, supported living services are a process which assists adolescents in housing arrangements and provides services to assure successful transition to independent living or with roommates in the community. Services include training in independent living skills. For substance abuse, services provide for the placement and monitoring of recipients who are participating in non-residential services; recipients who have completed or are completing substance abuse treatment; and those recipients who need assistance and support in independent or supervised living within a “live-in” environment.
Supported housing/living services assist persons with substance abuse and psychiatric disabilities in the selection of housing of their choice. These services also provide the necessary services and supports to assure their continued successful living in the community and transitioning into the community. For children with mental health problems, supported living services are a process which assists adolescents in housing arrangements and provides services to assure successful transition to independent living or with roommates in the community. Services include training in independent living skills. For substance abuse, services provide for the placement and monitoring of: recipients who are participating in non-residential services; recipients who have completed or are completing substance abuse treatment; and those recipients who need assistance and support in independent or supervised living within a “live-in” environment.