As Amended
SEC. 43-14-7. Services provided; persons eligible; contracts with local coordinating care entities to administer; case managers and interdisciplinary teams; payment for services.
(1) The Children's Advisory Council shall contract with the selected local coordinating care entity in the two (2) designated regions in the pilot program, and these entities shall administer the program according to the terms of the contract with the Children's Advisory Council.
(2) Persons eligible for services provided through the pilot system of care program are persons under the age of twenty-one (21) with serious emotional or behavioral disorders or mental illnesses who require services from a multiple services and multiple programs system, including other interagency programs which serve the children and youth to be served by this chapter including, but not limited to, Early Intervention Act of Infants and Toddlers, Section 41-87-1 et seq., Early Periodic Screening Diagnosis and Treatment, Section 43-13-117(5), waivered program for home- and community-based services for developmentally disabled people, Section 43-13-117(29), and waivered program for targeted case management services for children with special needs,
Section 43-13-117(31). Those children and youth to be served by this chapter who are eligible for Medicaid shall be screened through the Medicaid Early Periodic Screening Diagnosis and Treatment (EPSDT) and their needs for medically necessary services shall be certified through the EPSDT process. Children who are not Medicaid eligible, but who meet the other eligibility criteria, shall be screened through a process similar to EPSDT, and if determined eligible, shall have access to their necessary services in the pilot system of care program through a mechanism determined by the Children's Advisory Council and funded through the operating fund provided in Section 43-14-5.
(3) Services that may be provided through the pilot system of care program shall include, but not be limited to, intensive home-based intervention, respite, therapeutic recreational services, emergency and crisis management, care management, day treatment, diagnosis and therapy. Services provided through the pilot system of care program shall be provided in the home setting of the recipient whenever feasible, rather than in a clinical setting. Services in the community of the recipient shall be considered and implemented before authorizing a more restrictive, out-of-home community setting. Where appropriate, other interagency programs which serve the children and youth to be served by this chapter, including, but not limited to, Early Intervention Act of Infants and Toddlers, Section 41-87-1 et seq., Early Periodic Screening Diagnosis and Treatment, Section 43-13-117(5), waivered program for home- and community-based services for developmentally disabled people, Section 43-13-117(29), and waivered program for targeted case management services for children with special needs, Section 43-13-117(31), shall be utilized.
(4) The local coordinating care entity authorized to operate the pilot program shall employ case managers who shall be responsible for setting up an interdisciplinary team composed of members of the child's family or other primary caregivers, and appropriate professional service providers. This team shall determine an individualized and clinically appropriate plan of care for the child. The case manager shall arrange for those services called for in each plan of care to be provided to the child. Where appropriate other interagency programs which serve the children and youth to be served by this chapter, including, but not limited to, Early Intervention Act of Infants and Toddlers, Section 41-87-1 et seq., Early Periodic Screening Diagnosis and Treatment, Section 43-13-117(5), waivered program for home- and community-based services for developmentally disabled people, Section 43-13-117(29), and waivered program for targeted case management services for children with special needs, Section 43-13-117(31), shall be utilized.
(5) Payment for services dictated by the plan of care shall be made to the providers of the services by the selected local coordinating care entity in the two (2) designated regions utilizing the blended fund pool established for the pilot program.
SOURCES: Laws, 1993, ch. 388, Sec. 4, eff from and after July 1, 1993. Laws, 1994, ch. 649, Sec. 13; reenacted and amended, 1996, ch. 476, Sec. 4, eff from and after July 1, 1996, and shall stand repealed on July 1, 1998; reenacted, Laws, 1998, ch. 383, Sec. 4, HB 512, eff July 1, 1998, and shall stand repealed on July 1, 2000. Reenacted by Laws 2000, Ch. 547, Sec. 4, HB250, eff. July 1, 2000.
PREVIOUS VERSIONS: Pre-2000