Services

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Assessment

This Covered Service includes the systematic collection and integrated review of individual-specific data, such as examinations and evaluations. This data is gathered, analyzed, monitored and documented to develop the person’s individualized plan of treatment and to monitor recovery. Assessment specifically includes efforts to identify the person’s key medical and psychological needs, competency to consent to treatment, history of mental illness or substance use and indicators of co-occurring conditions, as well as clinically significant neurological deficits, traumatic brain injury, organicity, physical disability, developmental disability, need for assistive devices, and physical or sexual abuse or trauma.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Case Management

Case management services consist of activities that identify the recipient’s needs, plan services, link the service system with the person, coordinate the various system components, monitor service delivery, and evaluate the effect of the services received. This covered service shall include clinical supervision provided to a service provider’s personnel by a professional qualified by degree, licensure, certification, or specialized training in the implementation of this service.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Comprehensive Community Service Team

This Covered Service includes the systematic collection and integrated review of individual-specific data, such as examinations and evaluations. This data is gathered, analyzed, monitored and documented to develop the person’s individualized plan of treatment and to monitor recovery. Assessment specifically includes efforts to identify the person’s key medical and psychological needs, competency to consent to treatment, history of mental illness or substance use and indicators of co-occurring conditions, as well as clinically significant neurological deficits, traumatic brain injury, organicity, physical disability, developmental disability, need for assistive devices, and physical or sexual abuse or trauma.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Crisis Stabilization

These acute care services, offered twenty-four hours per day, seven days per week, provide brief, intensive mental health residential treatment services. These services meet the needs of individuals who are experiencing an acute crisis and who, in the absence of a suitable alternative, would require hospitalization.

Programs

Adult Mental Health and Children’s Mental Health

Crisis Support/Emergency

This non-residential care is generally available twenty-four hours per day, seven days per week, or some other specific time period, to intervene in a crisis or provide emergency care. Examples include: mobile crisis, crisis support, crisis/emergency screening, crisis telephone, and emergency walk-in.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Day Care

Day care services, in a non-residential group setting, provide for the care of children of persons who are participating in mental health or substance abuse services. In a residential setting, day care services provide for the residential and care-related costs of a child living with a parent receiving residential services.

Programs

Adult Mental Health and Adult Substance Abuse

Day Treatment

Day Treatment services provide a structured schedule of non-residential services for four or more consecutive hours per day. Activities for children and adult mental health programs are designed to assist individuals to attain skills and behaviors needed to function successfully in living, learning, work, and social environments. Activities for substance abuse programs emphasize rehabilitation, treatment, and education services, using multidisciplinary teams to provide integrated programs of academic, therapeutic, and family services.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Drop-in/Self-Help Centers

These centers are intended to provide a range of opportunities for persons with severe and persistent mental illness to independently develop, operate, and participate in social, recreational, and networking activities.

Programs

Adult Mental Health

Florida Assertive Community Treatment (FACT) Team

A FACT team is comprised of slots for participants with a severe and persistent mental illness. Participants are enrolled on a weekly basis. For a provider to identify themselves as a FACT team, the provider must demonstrate adherence to assertive community treatment principles. FACT Teams provide non-residential services that are available twenty-four hours per day, seven days per week. Rehabilitative, support and therapeutic services are provided in the community, by a multidisciplinary team.

Programs

Adult Mental Health and Adult Substance Abuse

Incidental Expenses

This Covered Service reports temporary expenses incurred to facilitate continuing treatment and community stabilization when no other resources are available. All incidental expenses shall be authorized by the Managing Entity. Allowable uses of this Covered Service include: transportation, childcare, housing assistance clothing, educational services, vocational services, medical care, housing subsidies, pharmaceuticals and other incidentals as approved by the department or Managing Entity.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Information and Referral

These services maintain information about resources in the community, link people who need assistance with appropriate service providers, and provide information about agencies and organizations that offer services. The information and referral process involves: being readily available for contact by the individual; assisting the individual with determining which resources are needed; providing referral to appropriate resources; and following up to ensure the individual’s needs have been met, where appropriate.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

In-Home and On-Site

Therapeutic services and supports, including early childhood mental health consultation, are rendered in non-provider settings such as nursing homes, assisted living facilities, residences, school, detention centers, commitment settings, foster homes, daycare centers, and other community settings.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Inpatient

Inpatient services provided in psychiatric units within hospitals licensed under Chapter 395, F.S. as general hospitals and psychiatric specialty hospitals. They are designed to provide intensive treatment to persons exhibiting violent behaviors, suicidal behaviors, and other severe disturbances due to substance abuse or mental illness.

Programs

Adult Mental Health and Children’s Mental Health

Intensive Case Management

Case management services consist of activities aimed at assessing recipient needs, planning services, linking the service system to a recipient, coordinating the various system components, monitoring service delivery, and evaluating the effect of services received. These services are typically offered to persons who are being discharged from a hospital or crisis stabilization unit who are in need of more professional care and who will have contingency needs to remain in a less restrictive setting.

Programs

Adult Mental Health and Children’s Mental Health.

Intervention

Intervention services focus on reducing risk factors generally associated with the progression of substance abuse and mental health problems. Intervention is accomplished through early identification of persons at risk, performing basic individual assessments, and providing supportive services, which emphasize short-term counseling and referral. These services are targeted toward individuals and families. This covered service shall include clinical supervision provided to a service provider’s personnel by a professional qualified by degree, licensure, certification, or specialized training in the implementation of this service.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Medical Services

Medical services provide primary psychiatric care, therapy, and medication administration provided by an individual licensed under the state of Florida to provide the specific service rendered. Medical services are designed to improve the functioning or prevent further deterioration of persons with mental health or substance abuse problems, including psychiatric mental status assessment. For adults with mental illness, medical services are usually provided on a regular schedule, with arrangements for non-scheduled visits during times of increased stress or crisis.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Medication-Assisted Treatment

This Covered Service provides for the delivery of medications for the treatment of substance use or abuse disorders which are prescribed by a licensed health care professional. Services must be based upon a clinical assessment and provided in conjunction with substance abuse treatment.

Programs

Adult Substance Abuse, Children’s Substance Abuse

Mental Health Clubhouse Services

Structured, evidence-based services designed to both strengthen and/or regain the individual’s interpersonal skills, provide psycho-social therapy toward rehabilitation, develop the environmental supports necessary to help the individual thrive in the community and meet employment and other life goals and promote recovery from mental illness. Services are typically provided in a community-based program with trained staff and members working as teams to address the individual’s life goals and to perform the tasks necessary for the operations of the program. The emphasis is on a holistic approach focusing on the individual’s strengths and abilities while challenging the individual to pursue those life goals. This service would include, but not be limited to, clubhouses certified under the International Center for Clubhouse Development.

Programs

Adult Mental Health

Outpatient

Outpatient services provide a therapeutic environment, which is designed to improve the functioning or prevent further deterioration of persons with mental health and/or substance abuse problems. These services are usually provided on a regularly scheduled basis by appointment, with arrangements made for non-scheduled visits during times of increased stress or crisis. Outpatient services may be provided to an individual or in a group setting. The group size limitations applicable to the Medicaid program shall apply to all Outpatient services provided by a SAMH-Funded Entity. This covered service shall include clinical supervision provided to a service provider’s personnel by a professional qualified by degree, licensure, certification, or specialized training in the implementation of this service.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse,and Children’s Substance Abuse

Outreach

Outreach services are provided through a formal program to both individuals and the community. Community services include education, identification, and linkage with high-risk groups. Outreach services for individuals are designed to: encourage, educate, and engage prospective individuals who show an indication of substance abuse and mental health problems or needs. Individual enrollment is not included in Outreach services.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse.

Prevention ‒ Indicated

Indicated prevention services are provided to at-risk individuals who are identified as having minimal but detectable signs or symptoms foreshadowing mental disorders or substance use disorders. Target recipients of indicated prevention services are at-risk individuals who do not meet clinical criteria for mental health or substance abuse disorders. Indicated prevention services are designed to preclude, forestall, or impede the development of mental health or substance abuse disorders. These services shall address the following specific prevention strategies, as defined in Rule 65D-30.013, F.A.C.: education, alternative and problem identification and referral services.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Prevention – Selective

Selective prevention services are provided to a population subgroup whose risk of developing mental health or substance abuse disorders is higher than average. Target recipients of selective prevention services do not meet clinical criteria for mental health or substance abuse disorders. Selective prevention services are designed to preclude, forestall, or impede the development of mental health or substance abuse disorders. These services shall address the following specific prevention strategies, as defined in Rule 65D-30.013, F.A.C.: information dissemination, education, alternatives, and problem identification and referral services.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Prevention – Universal Direct

Direct prevention services are provided to the general public or a whole population that has not been identified on the basis of individual risk. These services are designed to preclude, forestall, or impede the development of mental health or substance abuse disorders. Universal direct services directly serve an identifiable group of participants who have not been identified on the basis of individual risk. This includes interventions involving interpersonal and ongoing or repeated contact such as curricula, programs, and classes. These services shall address the following specific prevention strategies, as defined in Rule 65D-30.013, F.A.C.: information dissemination, education, alternatives, or problem identification and referral services.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Prevention – Universal Indirect

Universal indirect prevention services are provided to the general public or a whole population that has not been identified on the basis of individual risk. These services are designed to preclude, forestall, or impede the development of mental health or substance use disorders. Universal indirect services support population-based programs and environmental strategies such as changing laws and policies. These services can include programs and policies implemented by coalitions. These services can also include meetings and events related to the design and implementation of components of the strategic prevention framework, including needs assessments, logic models, and comprehensive community action plans. These services shall address the following specific prevention strategies, as defined in Rule 65D-30.013, F.A.C.: information dissemination, community-based processes, and environmental strategies.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse.

Recovery Support

These services are designed to support and coach an adult or child and family to regain or develop skills to live, work and learn successfully in the community. Services include substance abuse or mental health education, assistance with coordination of services as needed, skills training, and coaching. This Covered Service shall include clinical supervision provided to a service provider’s personnel by a professional qualified by degree, licensure, certification, or specialized training in the implementation of this service. For Adult Mental Health and Children’s Mental Health Programs, these services are provided by a Certified Family, Veteran, or Recovery Peer Specialist. For Adult and Children’s Substance Abuse programs, these services may be provided by a certified Peer Recovery Specialist or trained paraprofessional staff subject to supervision by a Qualified Professional as defined in Rule 65D-30.002, F.A.C. These services exclude twelve-step programs such as Alcoholics Anonymous and Narcotics Anonymous.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Residential Level I

These licensed services provide a structured, live-in, non-hospital setting with supervision on a twenty- four hours per day, seven days per week basis. A nurse is on duty in these facilities at all times. For adult mental health, these services include group homes. Group homes are for longer-term residents. These facilities offer nursing supervision provided by, at a minimum, licensed practical nurses on a twenty-four hours per day, seven days per week basis. For children with serious emotional disturbances, Level 1 services are the most intensive and restrictive level of residential therapeutic intervention provided in a non-hospital or non-crisis support unit setting, including residential treatment centers. Medicaid Residential Treatment Centers and Residential Treatment Centers are reported under this Covered Service. On-call medical care shall be available for substance abuse programs. Level 1 provides a range of assessment, treatment, rehabilitation, and ancillary services in an intensive therapeutic environment, with an emphasis on treatment, and may include formal school and adult education programs.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Residential Level II

Level II facilities are licensed, structured rehabilitation-oriented group facilities that have twenty-four hours per day, seven days per week, supervision. Level II facilities house persons who have significant deficits in independent living skills and need extensive support and supervision. For children with serious emotional disturbances, Level II services are programs specifically designed for the purpose of providing intensive therapeutic behavioral and treatment interventions. Therapeutic Group Home, Specialized Therapeutic Foster Home – Level II, and Therapeutic Foster Home – Level 2 are reported under this Covered Service. For substance abuse, Level II services provide a range of assessment, treatment, rehabilitation, and ancillary services in a less intensive therapeutic environment with an emphasis on rehabilitation, and may include formal school and adult educational programs.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse.

Residential Level III

These licensed facilities provide twenty-four hours per day, seven days per week supervised residential alternatives to persons who have developed a moderate functional capacity for independent living. For children with serious emotional disturbances, Level III services are specifically designed to provide sparse therapeutic behavioral and treatment interventions. Therapeutic Group Home, Specialized Therapeutic Foster Home – Level I, and Therapeutic Foster Home – Level 1 are reported under this Covered Service. For adults with serious mental illness, this Covered Service consists of supervised apartments. For substance abuse, Level III provides a range of assessment, rehabilitation, treatment and ancillary services on a long-term, continuing care basis where, depending upon the characteristics of the individuals served, the emphasis is on rehabilitation or treatment.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Residential Level IV

This type of facility may have less than twenty-four hours per day, seven days per week on-premise supervision. It is primarily a support service and, as such, treatment services are not included in this Covered Service, although such treatment services may be provided as needed through other Covered Services. Level IV includes satellite apartments, satellite group homes, and therapeutic foster homes. For children with serious emotional disturbances, Level IV services are the least intensive and restrictive level of residential care provided in group or foster home settings, therapeutic foster homes, and group care. Regular therapeutic foster care can be provided either through Residential Level IV “Day of Care: Therapeutic Foster Home” or by billing in-home/non-provider setting for a child in a foster home.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Respite Services

Respite care services are designed to sustain the family or other primary care giver by providing time-limited, temporary relief from the ongoing responsibility of care giving.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Room and Board with Supervision Level I

This Covered Service solely provides for room and board with supervision on a twenty-four hours per day, seven days per week basis. It corresponds to Residential Level I as defined in paragraph (4)(aa) of this rule. This Covered Service is not applicable for provider facilities which meet the definition of an Institute for Mental Disease as defined by Title 42 CFR, part 435.1010.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Room and Board with Supervision Level II

This Covered Service solely provides for room and board with supervision on a twenty-four hours per day, seven days per week basis. It corresponds to Residential Level II as defined in paragraph (4)(bb) of this rule. This Covered Service is not applicable for provider facilities which meet the definition of an Institute for Mental Disease as defined by Title 42 CFR, part 435.1010.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Room and Board with Supervision Level III

This Covered Service solely provides for room and board with supervision on a twenty-four hours per day, seven days per week basis. It corresponds to Residential Level III as defined in paragraph (4)(cc) of this rule. This Covered Service is not applicable for provider facilities which meet the definition of an Institute for Mental Disease as defined by Title 42 CFR, part 435.1010.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Short-term Residential Treatment

These individualized, stabilizing acute and immediately sub-acute care services provide short and intermediate duration intensive mental health residential and habilitative services on a twenty-four hours per day, seven days per week basis. These services shall meet the needs of individuals who are experiencing an acute or immediately sub-acute crisis and who, in the absence of a suitable alternative, would require hospitalization.

Programs

Adult Mental Health.

Substance Abuse Inpatient Detoxification

These programs utilize medical and clinical procedures to assist adults, children, and adolescents with substance abuse problems in their efforts to withdraw from the physiological and psychological effects of substance abuse. Residential detoxification and addiction receiving facilities provide emergency screening, evaluation, short-term stabilization, and treatment in a secure environment.

Programs

Adult Substance Abuse and Children’s Substance Abuse

Substance Abuse Outpatient Detoxification

These services utilize medication or a psychosocial counseling regimen that assists recipients in their efforts to withdraw from the physiological and psychological effects of the abuse of addictive substances.

Programs

Adult Substance Abuse and Children’s Substance Abuse.

Supported Employment

Supported employment services are evidence-based community-based employment services in an integrated work setting which provides regular contact with non-disabled co-workers or the public. A job coach provides longer-term, ongoing support for as long as it is needed to enable the recipient to maintain employment.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Supportive Housing/Living

Supported housing/living is an evidence-based approach to assist persons with substance abuse and mental illness in the selection of permanent housing of their choice. These services also provide the necessary services and supports to assure continued successful living in the community and transitioning into the community. For children with mental health problems, supported living services are a process which assists adolescents in housing arrangements and provides services to assure successful transition to independent living or with roommates in the community. Services include training in independent living skills. For substance abuse, services provide for the placement and monitoring of recipients who are participating in non-residential services; recipients who have completed or are completing substance abuse treatment; and those recipients who need assistance and support in independent or supervised living within a “live-in” environment.

Programs

Adult Mental Health, Children’s Mental Health, Adult Substance Abuse, and Children’s Substance Abuse

Treatment Alternatives for Safer Communities (TASC)

TASC provides for identification, screening, court liaison, referral and tracking of persons in the criminal justice system with a history of substance abuse or addiction.

Programs

Adult Substance Abuse and Children’s Substance Abuse