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Mental Health Skill Building Services

WHAT IS THE CRITERIA FOR THIS SERVICE?

Individuals age 18 and over shall meet all of the following criteria in order to be eligible to receive Mental Health Skill-Building Services:

  1. The individual must have a DSM 5 mental health disorder that has been documented by a physician.
  2. The individual requires individualized training in acquiring basic living skills such as symptom management; adherence to psychiatric and medication treatment plans; development and appropriate use of social skills and personal support system; personal hygiene; food preparation; or money management.
  3. The individual shall have a prior history of any of the following: psychiatric hospitalization; residential crisis stabilization, Intensive Community Treatment (ICT) or Program of Assertive Community Treatment (PACT) services; placement in a psychiatric residential treatment facility (RTC Level C); or Temporary Detention Order (TDO) pursuant to the Code of Virginia §37.2- 809(B) evaluation as a result of decompensation related to serious mental illness.
  4. The individual shall have had a prescription for anti-psychotic, mood stabilizing, or anti-depressant medications within the 12 months prior to the assessment date.  

WHAT IS YOUR RATIO OF CLIENTS TO STAFF IN THE PROGRAM?

We have one staff for every 4-6 clients for full-time staff, at a minimum. We have one staff for every 2-3 clients for part-time status staff. 

HOW LONG CAN CLIENTS RECEIVE SERVICES? HOW MUCH TIME PER WEEK IS SPENT WITH THE CLIENT?

A client initially receives up to 3 months of services, pending Service Authorization from Magellan or authorized provider. Each case is re-evaluated prior to termination and if needed a request for an additional 3 month extension is submitted. The amount of time per week is based on the client’s level of needs.

WHAT IS THE PROCESS FOR STARTING SERVICES?

Once a referral is generated and submitted, a Mental Health Specialist will be assigned to the case and a Clinical Assessment Specialist will contact and complete the assessment process with the client.  After completion of the assessment, the Mental Health Specialist assigned to the case begins working with them within 48 hours.

WHAT TYPES OF INSURANCE COVER THESE SERVICES?

True Life Destinations accepts Medicaid and is credentialed with all 6 Commonwealth Coordinated Care (CCC) Plus Providers.

Mental Health Psychosocial Rehabilitation Program

WHAT IS THE CRITERIA FOR THIS SERVICE?

The individual must demonstrate a clinical necessity for the service arising from a mental, behavioral, or emotional illness that results in significant functional impairments in major life activities and meet BOTH criteria A and B.

CRITERIA A:  Must meet TWO of the following criteria on a continuing or intermittent basis:

        1. Experience difficulty in establishing or maintaining normal interpersonal relationships to such a degree that they are at risk of psychiatric hospitalization, homelessness, or isolation from social supports;
        2. Experience difficulty in activities of daily living, such as maintaining personal hygiene, preparing food and maintaining adequate nutrition, or managing finances to such degree that health or safety is jeopardized;
        3. Exhibit such inappropriate behavior that repeated interventions documented by the mental health, social services, or judicial system are or have been necessary; or
        4. Exhibit difficulty in cognitive ability such that they are unable to recognize personal danger or significantly inappropriate social behavior.  “Cognitive” here is referring to the individual’s ability to process information, problem-solve and consider alternatives, it does not refer to an individual with an intellectual or other developmental disability.

CRITERIA B: Must meet ONE of the following criteria:

        1. Have experienced long-term or repeated psychiatric hospitalizations;  
        2. Experience difficulty in activities of daily living and interpersonal skills;
        3. Have a limited or non-existent support system;
        4. Be unable to function in the community without intensive intervention;
        5. Require long-term services to be maintained in the community.

CAN WE WORK WITH ADULTS WITH LIMTED MOBILITY?

Our policy states that we will not be able to provide services to individuals who are not able to ambulate independently, excluding individuals with walkers and canes. Seek guidance for individual clarification.

WHAT IS YOUR RATIO OF CLIENTS TO STAFF DURING PROGRAM HOURS?

We have one staff for every 4-10 clients present in the group setting, at a minimum. We also have a Licensed Professional Counselor in the building in the event of a crisis that requires more intervention.

CAN THE INDIVIDUAL RECEIVE MENTAL HEALTH SKILL BUILDING SERVICES AT THE SAME TIME?

Yes absolutely! This services is allowable in addition to other services as long as it is positively impacting their mental health and goals are not overlapping.

WHAT TYPES OF INSURANCE COVER THESE SERVICES?

True Life Destinations accepts Medicaid and is credentialed with all 6 Commonwealth Coordinated Care (CCC) Plus Providers.