Pathways C.M.H.

provides and supports a wide range of services

 Assertive Community Treatment (ACT) provides basic services and supports essential for people
with serious mental illness to maintain independence in the community. An ACT team will
provide behavioral health therapy and help with medications. The team may also help access
community resources and supports needed to maintain wellness and participate in social,
educational and vocational activities. ACT may be provided daily for individuals who participate.

 Assessment includes a comprehensive psychiatric evaluation, psychological testing, substance

use disorder screening, or other assessments, conducted to determine a person’s level of
functioning and behavioral health treatment needs. Physical health assessments are not part of
the CMH/PIHP services.

 Assistive Technology includes adaptive devices and supplies that are not covered under the
Medicaid Health Plan or by other community resources. These devices help individuals to better
take care of themselves, or to better interact in the places where they live, work, and play.

 Autism Related Services are for beneficiaries who are less than 21 years of age who are
diagnosed with Autism Spectrum Disorder. The benefit includes Applied Behavioral Analysis
services at two different levels: Comprehensive Behavioral Intervention (CBI) is a more intense
level of services (16-25 hours per week); Focused Behavioral Intervention (FBI) is a less intense
level of services (5-15 hours per week).

 Behavior Treatment Review: If a person’s illness or disability involves behaviors that they or
others who work with them want to change, their individual plan of services (IPOS, also known
as a Person Centered Plan or PCP) may include a plan that talks about the behavior. This plan is
often called a “behavior treatment plan.” The behavior treatment plan is developed during
person-centered planning (PCP)and then is approved and reviewed regularly by a team of
specialists to make sure that it is effective and dignified, and continues to meet the person’s
needs.

 Clubhouse Programs: are programs where members (consumers) and staff work side by side to
operate the clubhouse and to encourage participation in the greater community. Clubhouse
programs focus on fostering recovery, competency, and social supports, as well as vocational
skills and opportunities.

 Community Inpatient Services are hospital services used to stabilize a behavioral health
condition in the event of a significant change in symptoms, or in a behavioral health emergency.
Community hospital services are provided in licensed psychiatric hospitals and in licensed
psychiatric units of general hospitals.

 Community Living Supports (CLS) are activities provided by paid staff that help adults with
either serious mental illness or intellectual/developmental disabilities live independently and
participate actively in the community. Community Living Supports may also help families who
have children with special needs (such as intellectual/developmental disabilities or serious
emotional disturbance).
 Crisis Interventions are unscheduled individual or group services aimed at reducing or
eliminating the impact of unexpected events on behavioral health and wellbeing.

 Crisis Residential Services are short-term alternatives to inpatient hospitalization provided in a

licensed residential setting.

 Enhanced Pharmacy includes doctor-ordered nonprescription or over-the-counter items (such

as vitamins or cough syrup) necessary to manage your health condition(s) when a person’s
Medicaid Health Plan does not cover these items.

 Environmental Modifications are physical changes to a person’s home, car, or work

environment that are of direct medical or remedial benefit to the person. Modifications ensure
access, protect health and safety, or enable greater independence for a person with physical
disabilities. Note that other sources of funding must be explored first, before using Medicaid
funds for environmental modifications.

 Family Support and Training provides family-focused assistance to family members relating to
and caring for a relative with serious mental illness, serious emotional disturbance, or
intellectual/developmental disabilities. “Family Skills Training” is education and training for
families who live with and/or care for a family member who is eligible for the Children’s Waiver
Program.

 Fiscal Intermediary Services help individuals manage their service and supports budget and pay
providers if they are using a “self-determination” approach.

 Health Services include assessment, treatment, and professional monitoring of health

conditions that are related to or impacted by a person’s behavioral health condition. A person’s
primary care health professional will treat any other health conditions they may have.

 Home-Based Services for Children and Families are provided in the family home or in another
community setting. Services are designed individually for each family, and can include things like
behavioral health therapy, crisis intervention, service coordination, or other supports to the
family.

 Intensive Crisis Stabilization is another short-term alternative to inpatient hospitalization.

Intensive crisis stabilization services are structured treatment and support activities provided by
a behavioral health crisis team in the person’s home or in another community setting.

 Jail Diversion diverts individuals with serious mental illness from incarceration to qualifying
levels of care to address their mental health concerns in lieu of traditional judicial case
processing.

 Medication Administration is when a doctor, nurse, or other licensed medical provider gives an
injection, or an oral medication or topical medication.
 Medication Review is the evaluation and monitoring of medicines used to treat a person’s
behavioral health condition, their effects, and the need for continuing or changing their
medicines.

 Mental Health Therapy and Counseling for Adults, Children and Families includes therapy or
counseling designed to help improve functioning and relationships with other people.

 Nursing Home Mental Health Assessment and Monitoring includes a review of a nursing home
resident’s need for and response to behavioral health treatment, along with consultations with
nursing home staff.

 Occupational Therapy includes the evaluation by an occupational therapist of an individuals’

ability to do things in order to take care of themselves every day, and treatments to help
increase these abilities.

 Partial Hospital Services include psychiatric, psychological, social, occupational, nursing, music
therapy, and therapeutic recreational services in a hospital setting, under a doctor’s supervision.
Partial hospital services are provided during the day and participants go home at night.

 Peer-delivered and Peer Specialist Services Peer-delivered services such as drop-in centers are
entirely run by consumers of behavioral health services. They offer help with food, clothing,
socialization, housing, and support to begin or maintain behavioral health treatment. Peer
Specialist services are activities designed to help persons with serious mental illness in their
individual recovery journey and are provided by individuals who are in recovery from serious
mental illness. Peer Specialist Services are available to help you achieve your personal goals of
community inclusion, membership, independence and productivity.

 Personal Care in Specialized Residential Settings assists an adult with mental illness or
intellectual/developmental disabilities with activities of daily living, self-care and basic needs,
while they are living in a specialized residential setting in the community.

 Physical Therapy includes the evaluation by a physical therapist of a person’s physical abilities
(such as the ways they move, use their arms or hands, or hold their body), and treatments to
help improve their physical abilities.

 Prevention Service Models (such as Infant Mental Health, School Success, etc.) use both
individual and group interventions designed to reduce the likelihood that individuals will need
treatment from the public behavioral health system.

 Respite Care Services provide short-term relief to the unpaid primary caregivers of people
eligible for specialty services. Respite provides temporary alternative care, either in the family
home, or in another community setting chosen by the family.

 Skill-Building Assistance includes supports, services and training to help a person participate
actively at school, work, volunteer, or community settings, or to learn social skills they may need
to support themselves or to get around in the community.
 Speech and Language Therapy includes the evaluation by a speech therapist of a person’s ability
to use and understand language and communicate with others or to manage swallowing or
related conditions, and treatments to help enhance speech, communication or swallowing.

 Substance Use Disorder Treatment Services (descriptions follow the mental/behavioral health
services)

 Supported/Integrated Employment Services provide initial and ongoing supports, services and
training, usually provided at the job site, to help adults who are eligible for behavioral health
services find and keep paid employment in the community.

 Supports Coordination or Targeted Case Management A Supports Coordinator or Case

Manager is a staff person who helps write an individual plan of service (IPOS, also known as a
PCP) and makes sure the services are delivered. His or her role is to listen to a person’s desired
changes and/or goals, and to help find the services and providers inside and outside the local
CMH that will help achieve the desired changes and/or goals. A Supports Coordinator or Case
Manager may also connect a person to resources in the community for employment, community
living, education, public benefits, and recreational activities.

 Transportation may be provided to and from a person’s home in order for them to take part in a
non-medical Medicaid-covered service.

 Treatment Planning assists the person and those of his/her choosing in the development and
periodic review of the individual plan of services (IPOS, also known as a PCP).

 Wraparound Services for Children and Adolescents with serious emotional disturbance and
their families that include treatment and supports necessary to maintain the child in the family
home.

Co-Occuring Mental Health and Substance Use Disorder Treatment

 For Persons with Substance Use Disorders contact Northcare Network at 1-888-333-8030 to
access services:

 Access, Assessment and Referral (AAR) determines the need for substance abuse services and
will assist in getting to the right services and providers.