Outpatient Mental Health Treatment
• Individual, group and family therapy as well as medication monitoring provided by a professional in an office setting to discuss behavioral health issues.
Process:
• Current list of providers can be obtained from Magellan Service Center via phone, Member line: 866-238-2311 or Provider line: 866-780-3368. Consumer, parent or case manager would contact provider’s office to schedule an appointment.
• Children/Adolescents with Fee-for-Service Medical Assistance can contact Lehigh County Children’s Behavioral Health for assistance in obtaining an appointment, 610-782-3945.
Drug and Alcohol Outpatient Treatment
• Individual, group and family therapy as well as medication monitoring provided by a professional in an office setting to discuss behavioral health issues.
Process:
• Current list of providers can be obtained from Magellan Service Center via phone, Member line: 866-238-2311 or Provider line: 866-780-3368. Consumer, parent or case manager would contact provider’s office to schedule an appointment.
Psychiatric or Psychological Evaluation
• A comprehensive report completed following a face-to-face meeting with a psychiatrist or psychologist. Report will contain current mental health status, mental health history, current issues, diagnosis, and recommendations for treatment.
Process:
MBH consumers: Current list of providers can be obtained from Magellan Service Center via phone, Member line: 866-238-2311 or Provider line: 866-780-3368. Consumer, parent or case manager would contact provider’s office to schedule an appointment.
FFS consumers: Children/Adolescents with Fee-for-Service Medical Assistance can contact Lehigh County Children’s Behavioral Health for assistance in obtaining an appointment, 610-782-3945.
Intensive Case Management
• A case manager is assigned to an individual when they have been identified as requiring intensive supports and monitoring. The case manager assists the individual and the family in accessing mental health treatment programs, facilitates coordination between the systems involved, and links to community resources. An Intensive Case Manager (ICM) must meet face-to-face with the individual a minimum of every two weeks and offers mental health crisis intervention 24 hours per day, 7 days per week.
Process:
• Current list of providers can be obtained from Magellan Service Center via phone, Member line: 866-238-2311 or Provider line: 866-780-3368. Consumer, parent or case manager would contact provider’s office to schedule an appointment. Consumer will need a current evaluation with diagnosis and mental health history.
Resource Coordination
• A case manager is assigned to an individual when they have been identified as requiring intensive supports and monitoring. The case manager assists the individual and the family in accessing mental health treatment programs, facilitates coordination between the systems involved, and links to community resources. Resource Case Manager (RC) must meet face-to-face with the individual a minimum of once per month.
Process:
• Current list of providers can be obtained from Magellan Service Center via phone, Member line: 866-238-2311 or Provider line: 866-780-3368. Consumer, parent or case manager would contact provider’s office to schedule an appointment. Consumer will need a current evaluation with diagnosis and mental health history.
Behavioral Health Rehabilitative Services (BHRS)
• Mobile Therapy, Behavior Specialist Consultant, Therapeutic Staff Support
BHRS is an in-home community-based mental health treatment program. This service can also take place in the school environment. The Mobile Therapist (Master’s level professional) provides individual and family therapy. The Behavioral Specialist Consultant (Master’s level professional) helps the individual, family, etc. develop a behavior plan to build on the individual’s strengths and to decrease negative behaviors. The therapeutic staff support, TSS (Bachelor’s level professional) assists the individual in completing the goals on the collaboratively developed treatment plan and teaches the parents to utilize the interventions.
Process:
• A psychiatrist or psychologist prescribes based on medical necessity and the individual’s needs. The prescription consists of a prescribed amount of hours and specific roles for mobile therapy, behavior therapy, and/or therapeutic staff support as well as indicates the location of services.
MBH Consumers : Current list of providers can be obtained from Magellan Service Center via phone, Member line: 866-238-2311 or Provider line: 866-780-3368. Consumer, parent or case manager would contact provider’s office to schedule an appointment. An ISPT meeting is held and request for authorization packet is submitted to the MBH to determine medical necessity. This service requires an approved prior to starting.
FFS Consumers: Provider will complete referral form and forward to Lehigh County Children’s Behavioral Health Unit along with a signed release of information and current evaluation. Case manager will assist family in identifying an available provider. An ISPT meeting is held and request for authorization packet is submitted to the Office of Medical Assistance to determine medical necessity. This service requires an approval prior to starting.
Autism Summer Camp (KidsPeace- Sarah Smiles)
• A six-week therapeutic summer camp for children with a diagnosis of an Autism Spectrum Disorder.
Process:
• A psychiatrist or psychologist completes an evaluation prescribing summer therapeutic activity program. Current list of providers can be obtained from Magellan Service Center via phone, Member line: 866-238-2311 or Provider line: 866-780-3368. Consumer, parent or case manager would contact provider’s office to schedule an appointment to determine appropriateness for program. An ISPT meeting is held and request for authorization packet is submitted to the MBH to determine medical necessity. This service requires an approval prior to starting.
Family Based Mental Health Services
• An intensive six-month to eight-month in-home mental health treatment program, which offers individual and family therapy with a team of two therapists (Master’s degree and Bachelor’s degree professionals). Case management services, 24-hour crisis intervention, and psychotropic medication monitoring are available for the duration of the program.
Process:
• A psychiatrist or psychologist completes an evaluation prescribing Family Based Mental Health Services.
MBH Consumers : Current list of providers can be obtained from Magellan Service Center via phone, Member line: 866-238-2311 or Provider line: 866-780-3368. Consumer, parent or case manager would contact provider’s office to schedule an appointment. An initial meeting is held and request for authorization packet is submitted to MBH to determine medical necessity. This service requires an approval prior to starting.
FFS Consumers: Provider will complete referral form and forward to Lehigh County Children’s Behavioral Health Unit along with a signed release of information and current evaluation. Case manager will assist family in identifying an available provider. A request for authorization packet is submitted to the Office of Medical Assistance to determine medical necessity as well as Metal Health Base Funds Form is submitted to Lehigh County CBHU. This service requires an approved prior to starting.
Partial Hospitalization Program
• Acute Partial Hospitalization Program: Individuals up to age 21 (if attending high school) attend the program during school hours and participate in intensive individual and group therapy. Participants are allotted structured time during the program day for completing school assignments. A psychiatrist is available to prescribe and monitor psychotropic medication, when needed, for the duration of the program.
• School Based Partial Hospitalization Program: Schools have a partial hospitalization program stationed within the school building. Two mental health professionals (from Carbon Lehigh Intermediate Unit #21) are in each school, and are available for individual therapy, consultation, crisis management, and support during the school day. A psychiatrist is available to prescribe and monitor psychotropic medication, if needed. Treatment planning meetings must occur every 20 days, to review progress and medical necessity.
Process:
• A psychiatrist or psychologist completes an evaluation prescribing the type of partial program. Current list of providers can be obtained from Magellan Service Center via phone, Member line: 866-238-2311 or Provider line: 866-780-3368. Consumer, parent or case manager would contact provider’s office to schedule an appointment.
Community Rehabilitative Residence (CRR)
• Community Rehabilitative Residence (CRR) Host Home: CRR Host Homes are intensive out of home treatment services. The individual resides with a family who is trained to work with children experiencing behavioral and emotional difficulty. The service provides individual, group and family therapy as well as medication monitoring. The consumer attends school within the community of the host home.
• Community Rehabilitative Residence (CRR) Group Home: CRR Group Home is an intensive out of home treatment services. The individual resides within a group home trained to work with adolescents experiencing behavioral and emotional difficulty. The service provides individual, group and family therapy as well as medication monitoring. The consumer attends school within the community of the group home.
Process:
• This service is available to children with Medical Assistance (MA) eligibility, who meet Medical necessity criteria for this leave of care. The consumer must have the services prescribed by a psychologist or psychiatrist and have a CASSP meeting as well as be deemed medically necessary by the local MCO or DPW. A current evaluation, referral form and release of information are forwarded to the Lehigh County CASSP Unit, 610-782-3376. CASSP meeting will be held with all parties involved in the child’s life including, but not limited to current provider, child serving system, MCO, and family.
MBH Consumers: A request for authorization is submitted to MBH within seven days of the meeting. MBH will determine medical necessity within two days and contact family. If deemed medically necessary MBH will complete the search for an available bed. MBH will provide a choice of two providers to the child and family to select from.
FFS Consumer: Following the meeting the CASSP case manager will search for an available bed. Upon selection of facility and bed availability within thirty days, the request of authorization for services will be submitted to the Office of Medical Assistance for review. OMAP will determine medical necessity within twenty-one days.
Residential Treatment Facility (RTF)
• A RTF is an intensive out of home treatment service. The consumer resides at a facility and receives twenty-four hour supervision. The consumer is provided with individual, group, and family therapy and medication monitoring to address their behavioral treatment goals. The consumer typically attends the on grounds school provided by the facility. The RTF also provided specialized therapies including recreation and art. The consumer does participate in therapeutic leave passes to their home to practice the skills he/she has developed.
Process:
• This service is available to children with Medical Assistance (MA) eligibility, who meet Medical necessity criteria for this leave of care. The consumer must have the services prescribed by a psychiatrist and have a CASSP meeting as well as be deemed medically necessary by the local MCO or DPW. A current evaluation, referral form and release of information are forwarded to the Lehigh County CASSP Unit, 610-782-3376. CASSP meeting will be held with all parties involved in the child’s life including, but not limited to current provider, child serving system, MCO, and family.
MBH Consumers: A request for authorization is submitted to MBH within seven days of the meeting. MBH will determine medical necessity within two days and contact family. If deemed medically necessary MBH will complete the search for an available bed. MBH will provide a choice of two providers to the child and family to select from.
FFS Consumer: Following the meeting the CASSP case manager will search for an available bed. Upon selection of facility and bed availability within thirty days, the request of authorization for services will be submitted to the Office of Medical Assistance for review. OMAP will determine medical necessity within twenty-one days.
Inpatient Psychiatric Hospitalization
• Twenty-four hour acute mental health treatment provided in a hospital setting. The consumer is provided with individual, group, and family therapy and medication monitoring to address their behavioral treatment goals. Children are allotted structured time during the program day for completing school assignments.
Process:
• A licensed professional in either an office setting, home, or emergency room visit must evaluate individual. If the consumer has an ICM, the case manager must complete a face-to-face visit prior to admission. The evaluator contacts Magellan for review of medical necessity. If deemed medically necessary MBH will complete the bed search and ambulance service if necessary.
Drug and Alcohol Inpatient Treatment
• Treatment program located within a hospital environment to assist individual with detoxification and treatment to stay drug and alcohol free.
Process:
• An evaluation or outpatient initial assessment recommending need for inpatient services is completed and forwarded to Magellan. Provider reviews with Magellan to determine medical necessity. If deemed medically necessary MBH will complete the bed search.