Eligibility Community Stabilization
Individuals must meet the following criteria:
- Documentation indicates evidence that the individual currently meets criteria for a primary diagnosis consistent with the most recent version of the International Statistical Classification of Diseases and Related Health Problems (ICD) diagnosis that correlates with the Diagnostic and Statistical Manual; and
- The individual has demonstrated a level of acuity indicating that they are at risk for crisis-cycling or dangerous decompensation in functioning and additional support in the form of community stabilization is required to prevent an acute inpatient admission; and
- Prior to admission the individual must meet either a. or b. below:
a. The individual is residing in a Therapeutic Group Home or ASAM 3.1; or
b. The individual needs community stabilization as a transition due to either i. or ii. below and also meets iii. below:
i. A LMHP, LMHP-R, LMHP-RP or LMHP-S at a Community Services Board (CSB) same day access intake, a Managed Care Organization, or Fee-For-Service contractor determines CS is needed to support a transition in care and link an individual to appropriate services; or
ii. The individual is being discharged from one of the below services:
(a) 23-Hour Crisis Stabilization(b) Acute Psychiatric Inpatient Services
(c) ASAM levels 3.1 – 4.0
(d) Hospital Emergency Department
(e) Short-term detention or incarceration
(f) Mobile Crisis Response
(g) Partial Hospitalization Program (Mental Health or ARTS)
(h) Psychiatric Residential Treatment Facility
(i) Residential Crisis Stabilization Unit
(j) Therapeutic Group Home
iii. Individuals meeting either criteria i. or criteria ii. above must also meet the following additional criteria:
(a) The service that the individual needs and is recommended by a professional listed in item i. above or a professional coordinating the discharge plan from services listed in item ii. above is not currently available for immediate access;
(b) A clinically appropriate and specific behavioral health service provider referral (s)) has been identified and a plan for the timeline of transition from Community Stabilization to that provider has been established and documented. If the timeline for this transition exceeds 2 weeks, the CS provider has documented communications with additional, specific service providers to support alternative service options or potentially faster access to the recommended service type.