Current through December 10, 2024
Rule 24-2-16.1 - Determinations of Serious Emotional Disturbance (SED), Serious Mental Illness (SMI), and/or Intellectual/Developmental Disability (IDD)A. All of the following information must be documented to support a determination of SED: 1. Child/youth has at least one (1) of the eligible diagnosable mental disorders defined in the most current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM).2. Age criterion: Child/youth with SED are birth up to 18 years of age.3. The identified disorder must have resulted in functional impairment in basic living skills, instrumental living skills, or social skills, as indicated by an assessment instrument/approach approved by DMH.B. All of the following information must be documented to support a determination of SMI and/or SUD: 1. A person who meets the criteria for one (1) of the eligible diagnostic categories defined in the most current version of the DSM.2. Age criterion: SMI and/or SUD are age 18 and over.3. The identified disorder must have resulted in functional impairment in basic living skills, instrumental skills, or social skills, as indicated by an assessment instrument/approach approved by DMH.C. All of the following must be documented to determine eligibility and support admission to IDD services: 1. All people interested in IDD Services must first be determined eligible through an evaluation by the Diagnostic and Evaluation (D and E) Team at one (1) of the state's intermediate care facility for people intellectual disabilities (ICF/IID) Regional Programs.2. For ID/DD Waiver Services, the person: (a) Meets the criteria for the level of care found in an ICF/IID;(b) Has an intellectual disability, developmental disability, and/or autism spectrum disorder as defined in the approved waiver application; and(c) Is eligible for Medicaid through one (1) of the categories specified in the federally approved ID/DD Waiver application.3. For the IDD Community Support Program (CSP), the person: (a) Has an intellectual disability, developmental disability, and/or autism spectrum disorder,(b) Meets the Needs-Based Criteria established in the 1915(i) Medicaid State Plan Amendment;(c) Is eligible for Full Medicaid Benefits; and(d) Is 18 years of age or older and no longer attends school.4. Eligibility for IDD Targeted Case Management is the same as for the IDD Community Support Program but may be provided to people of all ages.5. Other IDD Services: Meets the requirements for a Certificate of Developmental Disability as defined in the Developmental Disabilities Assistance Act.