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YOUR MEMBER HANDBOOK HAS BEEN CHANGED TO ADD SERVICES

MEDICAID ADVANTAGE PLUS (MAP)

Starting January 1, 2023, [Insert Plan Name] will cover behavioral health (mental health and addiction) services. You may have had some of these services before and now you can use your [Insert Plan Name] plan card to get these services. The services your plan will cover now include:

Adult outpatient mental health care

  • Continuing Day Treatment (CDT)
  • Partial Hospitalization (PH)

Adult outpatient rehabilitative mental health care

  • Assertive Community Treatment (ACT)
  • Mental Health Outpatient Treatment and Rehabilitative Services (MHOTRS)
  • Personalized Recovery Oriented Services (PROS)

Adult outpatient rehabilitative mental health and addiction services for members who meet clinical requirements. These are also known as CORE.

  • Community Oriented Recovery and Empowerment (CORE) Services:
    • Psychosocial Rehabilitation (PSR)
    • Community Psychiatric Supports and Treatment (CPST)
    • Empowerment Services - Peer Supports
    • Family Support and Training (FST)

Adult mental health crisis services

  • Comprehensive Psychiatric Emergency Program (CPEP)
  • Mobile Crisis and Telephonic Crisis Services
  • Crisis Residential Programs

Adult outpatient addiction services

  • Opioid Treatment Centers (OTP)

Adult residential addiction services

  • Residential Services

Adult Inpatient addiction rehabilitation services

  • State Operated Addiction Treatment Center’s (ATC).
  • Inpatient Addiction Rehabilitation
  • Inpatient Medically Supervised Detox

How do I get these services?
To learn more about these services, call Member Services at <Member Services Phone Number>. You may also discuss how to access specialized services, like CORE with your providers.

Attachment: Descriptions for Behavioral Health Services into MAP Insert

Adult Outpatient Mental Health Care

  • Continuing Day Treatment (CDT): Provides seriously mentally ill adults with the skills and supports necessary to remain in the community and be more independent. You can attend several days per week with visits lasting more than an hour.
  • Partial Hospitalization (PH): A program which provides mental health treatment designed to stabilize or help acute symptoms in a person who may need hospitalization.

Adult Outpatient Rehabilitative Mental Health Care

  • Assertive Community Treatment (ACT): ACT is a team approach to treatment, support, and rehabilitation services. Many services are provided by ACT staff in the community or where you live. ACT is for individuals that have been diagnosed with serious mental illness or emotional problems.
  • Mental Health Outpatient Treatment and Rehabilitative Services (MHOTRS): A program that provides treatment, assessment, and symptom management. Services may include individual and group therapies at a clinic location in your community.
  • Personalized Recovery Oriented Services (PROS): A complete recovery-oriented program if you have severe and ongoing mental illness. The goal of the program is to combine treatment, support, and therapy to aid in your recovery.

Adult Outpatient Rehabilitative Mental Health And Addiction Services For Members Who Meet Clinical Requirements. These are also known as CORE.

Community Oriented Recovery and Empowerment (CORE) Services:
Person-centered, recovery program with mobile behavioral health supports to help build skills and promote community participation and independence. CORE Services are available for members who have been identified by the State as meeting the high need behavioral health risk criteria. Anyone can refer or self-refer to CORE Services.

  • Psychosocial Rehabilitation (PSR): This service helps with life skills, like making social connections; finding or keeping a job; starting or returning to school; and using community resources.
  • Community Psychiatric Supports and Treatment (CPST): This service helps you manage symptoms through counseling and clinical treatment.
  • Empowerment Services - Peer Supports: This service connects you to peer specialists who have gone through recovery. You will get support and assistance with learning how to:
  • live with health challenges and be independent,
  • help you make decisions about your own recovery, and
  • find natural supports and resources.
  • Family Support and Training (FST): This service gives your family and friends the information and skills to help and support you.

Adult Mental Health Crisis Services

  • Comprehensive Psychiatric Emergency Program (CPEP): A hospital-based program which provides crisis supports and beds for extended observation (up to 72 hours) to individuals who need emergency mental health services.
  • Mobile Crisis and Telephonic Crisis Services: An in-community service that responds to individuals experiencing a mental health and/or addiction crisis.
  • Crisis Residential Programs: A short term residence that provides 24 hours per day services up to 28 days, for individuals experiencing mental health symptoms or challenges in daily life that makes symptoms worse. Services can help avoid a hospital stay and support the return to your community.

Adult Outpatient Addiction Services

  • Opioid Treatment Centers (OTP) are OASAS certified sites where medication to treat opioid dependency is given. These medications can include methadone, buprenorphine, and suboxone. These facilities also offer counseling and educational services. In many cases, you can get ongoing services at an OTP clinic over your lifetime.

Adult Residential Addiction Services

  • Residential Services are for people who are in need of 24-hour support in their recovery in a residential setting. Residential services help maintain recovery through a structured, substance-free setting. You can get group support and learn skills to aid in your recovery.

Adult Inpatient Addiction Rehabilitation Services

  • State Operated Addiction Treatment Center’s (ATC) provide care that is responsive to your needs and supports long-term recovery. Staff at each facility are trained to help with multiple conditions, such as mental illness. They also support aftercare planning. Types of addiction treatment services are different at each facility but can include medication-assisted treatment; problem gambling, gender-specific treatment for men or women, and more.
  • Inpatient Addiction Rehabilitation programs can provide you with safe setting for the evaluation, treatment, and rehabilitation of substance use disorders. These facilities offer 24-hour, 7-day a-week care that is supervised at all times by medical staff. Inpatient services include management of symptoms related to addiction and monitoring of the physical and mental complications resulting from substance use.
  • Inpatient Medically Supervised Detox programs offer inpatient treatment for moderate withdrawal and include supervision under the care of a physician. Some of the services you can receive are a medical assessment within twenty-four (24) hours of admission and medical supervision of intoxication and withdrawal conditions.