Service Protocols

In this section, practioners will find the guidelines they need to determine whether an individual qualifies for services. The guidelines will help the practitioner decide what services are medically necessary given specific diagnoses.

Table of Contents

Guiding Principles for the Thumb Alliance PIHP

Practice Guidelines for Children with SED - Access and Admission Eligibility Criteria

Practice Guidelines for Developmental Disabilities - Children & Adults Access & Admission Eligibility Criteria

Practice Guidelines for Severe Mental Illness - Adults Access & Admission Eligibility Criteria

Medicaid State Plan 1915 (B) Services:

Behavioral Management Review

Assertive Community Treatment (ACT)

Community Inpatient - Local Hospital

Crisis Residential Services

Psychological Testing

Occupational Therapy (All Services)

Personal Care in Specialized Residential Settings

Health Assessment

Home-Based Services (Ages 0-3)

Home-Based Services (Ages 4-6)

Home-Based Services (Ages 7-17)

Medicaid Habilitation Supports Waiver (HSW) 1915 (C) for Persons with Developmental Disabilities

Community Living Supports (CLS) - All Services

Support and Service Coordination (CLS)

Additional Mental Health Services - Medicaid 1915 (B) (3)

Community Living Supports (CLS) - All Services

Support and Service Coordination

Skill Building Assistance

Targeted Case Management

Rating Scales, Screening Tools, and Assessment instruments