BEHAVIORAL HEALTH SERVICES PROVIDER MANUAL

BEHAVIORAL HEALTH SERVICES PROVIDER MANUAL

Chapter Two of the Medicaid Services Manual Issued March 14, 2017

State of Louisiana Bureau of Health Services Financing

LOUISIANA MEDICAID PROGRAM

ISSUED:

02/23/22

REPLACED: 02/21/22

CHAPTER 2: BEHAVIORAL HEALTH SERVICES

SECTION: TABLE OF CONTENTS

PAGE(S) 11

BEHAVIORAL HEALTH SERVICES

TABLE OF CONTENTS

SUBJECT

OVERVIEW

PROVIDER REQUIREMENTS

BED BASED SERVICES

Therapeutic Group Homes

Components Provider Qualifications Additional Organizational Requirements Agency Staffing Qualifications Allowed Provider Types and Specialties Eligibility Criteria Service Utilization Service Exclusions Allowed Mode(s) of Delivery Additional Service Criteria TGH Cost Reporting Requirements

Psychiatric Residential Treatment Facilities

Plan of Care Provider Qualifications Agency Additional Organizational Requirements Staff Staffing Treatment Model and Service Delivery Allowed Provider Types and Specialties Eligibility Criteria Limitations/Exclusions

SECTION SECTION 2.0 SECTION 2.1 SECTION 2.2

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Table of Contents

LOUISIANA MEDICAID PROGRAM

ISSUED:

02/23/22

REPLACED: 02/21/22

CHAPTER 2: BEHAVIORAL HEALTH SERVICES

SECTION: TABLE OF CONTENTS

PAGE(S) 11

OUTPATIENT SERVICES

SECTION 2.3

Behavioral Health Services in a Federally Qualified Health Center or Rural Health Center

Provider Qualifications Agency or Group Practice Allowed Provider Types and Specialties Eligibility Criteria Allowed Mode(s) of Delivery

Crisis Services

Crisis Response Services for Adults Common Components

Preliminary Screening Assessments Interventions Care Coordination Service Delivery Provider Responsibilities Supervision of Non-Licensed Staff Documentation Reporting Requirements Provider Qualifications Agency/Facility Staff Mobile Response Components Eligibility Criteria Service Utilization Allowed Modes of Delivery Staffing Requirements Response Team Staffing Requirements Allowed Provider Types and Specialties Exclusions Billing Behavioral Health Crisis Care Components Eligibility Criteria Service Utilization Allowed Mode(s) of Delivery Staffing Requirements Allowed Provider Types and Specialties

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LOUISIANA MEDICAID PROGRAM

ISSUED:

02/23/22

REPLACED: 02/21/22

CHAPTER 2: BEHAVIORAL HEALTH SERVICES

SECTION: TABLE OF CONTENTS

PAGE(S) 11

Community Based Agency (new or current provider type) Exclusions Community Brief Crisis Support (CBCS) Components Eligibility Criteria Service Utilization Allowed Mode(s) of Delivery Allowed Places of Service Staffing Requirements Allowed Provider Types and Specialties Exclusions Billing

Individual Placement and Support

Evaluation of the Evidence Based Practice Components Eligibility Criteria Service Utilization Service Delivery

Staff Ratios

Allowed Provider Types and Specialties Allowed Modes of Delivery Provider Responsibilities

Supervision Provider Qualifications

Agency IPS Fidelity Standards New Teams Existing Teams IPS Specialist IPS Peer Specialist (Optional staff, but recommended) IPS Supervisor IPS Training and Recertification Limitations/Exclusions Billing

Outpatient Therapy by Licensed Practitioners

Provider Qualifications Agency or Group Practice Allowed Provider Types and Specialties

Eligibility Criteria Limitations/Exclusions Allowed Mode(s) of Delivery

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LOUISIANA MEDICAID PROGRAM

ISSUED:

02/23/22

REPLACED: 02/21/22

CHAPTER 2: BEHAVIORAL HEALTH SERVICES

SECTION: TABLE OF CONTENTS

PAGE(S) 11

Additional Service Criteria Telehealth

Peer Support Services

Evaluation and Evidence Based Practices Components Eligibility Criteria Allowed Modes of Delivery Service Utilization Service Delivery Staff Ratios Provider Responsibilities

Supervisions Provider Qualifications

Agency Staff CPSS Training and Certification Allowed Partner Types and Specialties Limitations/Exclusions

Personal Care Services

Components Eligibility Criteria Service Utilization Service Delivery Allowed Mode(s) of Delivery Provider Responsibilities Service Documentation Service Logs Back-Up Staffing & Emergency Evacuation Plans Provider Qualifications

Agency Staff Allowed Provider Types and Specialties Limitations/Exclusions Billing

Rehabilitation Services for Children, Adolescents, and Adults

Children and Adolescents Adults Service Delivery Assessment and Treatment Planning

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LOUISIANA MEDICAID PROGRAM

ISSUED:

02/23/22

REPLACED: 02/21/22

CHAPTER 2: BEHAVIORAL HEALTH SERVICES

SECTION: TABLE OF CONTENTS

PAGE(S) 11

Provider Responsibilities Core Services The BHSP Crisis Mitigation Plan Core Staffing Staff Supervision for Non-Licensed Staff

Eligibility Criteria Additional Adult Eligibility Criteria for Community Psychiatric Support and Treatment (CPST) and Psychosocial Rehabilitation (PSR) Adults receiving CPST and/or PSR must have at least Service Utilization Additional Service Utilization Criteria Member Choice Form and Process Limitations/Exclusions Community Psychiatric Support and Treatment

Components CPST Provider Qualifications

Agency Staff CPST Allowed Provider Types and Specialties CPST Allowed Mode(s) of Delivery CPST Additional Service Criteria CPST Staff Ratio(s) Psychosocial Rehabilitation Components PSR Provider Qualifications Agency Staff PSR Allowed Provider Types and Specialties PSR Allowed Mode(s) of Delivery PSR Staff Ratio(s) Crisis Intervention Components Provider Qualifications Agency Staff CI Allowed Provider Types and Specialties CI Eligibility Criteria CI Service Utilization CI Allowed Mode(s) of Delivery CI Additional Service Criteria Crisis Stabilization Components CS Provider Qualifications

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LOUISIANA MEDICAID PROGRAM

ISSUED:

02/23/22

REPLACED: 02/21/22

CHAPTER 2: BEHAVIORAL HEALTH SERVICES

SECTION: TABLE OF CONTENTS

PAGE(S) 11

Agency Staff CS Allowed Provider Types and Specialties CS Limitations/Exclusions CS Allowed Mode(s) of Delivery

ADDICTION SERVICES

SECTION 2.4

ASAM Levels Covered

Provider Qualifications

Agency

Staff

Allowed Provider Types and Specialties

Eligibility Criteria

Allowed Mode(s) of Delivery

Additional Service Criteria

ASAM Level 1 in an Outpatient Setting

Admission Guidelines for ASAM Level 1

Additional Admission Guidelines for Outpatient Treatment

Screening/Assessment/Treatment Plan Review

Provider Qualifications

Agency

Staff

Staffing Requirements

Additional Staffing and Service Components

ASAM Level 2.1 Intensive Outpatient Treatment

Admission Guidelines for ASAM Level 2.1 Intensive Outpatient Treatment

Additional Admission Guidelines for Intensive Outpatient Treatment

Screening/Assessment/Treatment Plan Review

Provider Qualifications

Staffing Requirements

Additional Staffing and Service Components

ASAM Level 2-WM Ambulatory Withdrawal Management with Extended On-Site

Monitoring

Admission Guidelines for ASAM Level 2-WM Ambulatory Withdrawal

Management with Extended On-Site Monitoring

Screening/Assessment/Treatment Plan Review

Provider Qualifications

Staffing Requirements

Additional Staffing and Service Components

Allowed Provider Types and Specialties

Eligibility Criteria

Allowed Mode(s) of Delivery

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LOUISIANA MEDICAID PROGRAM

ISSUED:

02/23/22

REPLACED: 02/21/22

CHAPTER 2: BEHAVIORAL HEALTH SERVICES

SECTION: TABLE OF CONTENTS

PAGE(S) 11

Additional Service Criteria ASAM Level 3.1: Clinically managed low-intensity residential treatment- Adolescent

Admission Guidelines Screening, Assessment, and Treatment Plan Review Provider Qualifications Staffing Requirements Additional Staffing and Service Components ASAM Level 3.1: Clinically managed low-intensity residential treatment- Adults Admission Guidelines Screening, Assessment, and Treatment Plan Review Provider Qualifications Staffing Requirements Additional Staffing and Service Components ASAM Level 3.2-WM: Clinically managed residential social withdrawal management ? Adolescent Admission Guidelines Emergency Admissions Screening, Assessment, and Treatment Plan Review Provider Qualifications Staffing Requirements Additional Staffing and Service Components Minimum Standards of Practice ASAM Level 3.-2WM: Clinically managed residential social withdrawal management ? Adults Admission Guidelines Emergency Admissions Screening, Assessment, and Treatment Plan Review Provider Qualifications Staffing Requirements Additional Staffing and Service Components Minimum Standards of Practice ASAM Level 3.3: Clinically managed population specific high intensity residential treatment- Adult Admission Guidelines Screening, Assessment, and Treatment Plan Review Provider Qualifications Staffing Requirements Additional Staffing and Service Components Minimum Standards of Practice Women with Dependent Children Program ASAM Level 3.5: Clinically managed medium intensity residential treatment ? Adolescent Admission Guidelines

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