Who’s Eligible

ELIGIBILITY REQUIRMENTS

We accept Virginia Medicaid and Anthem HealthKeepers Medicaid-Medicare Plan insurance; the following eligibility requirements apply to those insurances only.

Any person paying directly for the service can receive customized service to his or her liking and are not bound by the eligibility requirements listed below.

LIFE-SKILLS TRAINING FOR OLDER ADOLESCENTS AND ADULTS – MENTAL HEALTH SKILL-BUILDING SERVICE

We are happy to serve any 16 years or older adolescent* or adult who meets all of the following four criteria:

  1. Has a primary diagnosis of schizophrenia or other psychotic disorder, major depressive disorder (recurrent), or bipolar disorder I or II
  2. Requires individualized, goal-directed training in acquiring or maintaining self-regulation of basic living skills
  3. Has a history of any of the following:
    • Psychiatric hospitalization
    • Residential crisis stabilization
    • Intensive Community Treatment (ICT)
    • Program of Assertive Community Treatment (PACT) services
    • Placement in a psychiatric residential treatment facility (RTC Level C)
    • TDO evaluation as a result of decompensation related to serious mental illness
  4. Has had a prescription for anti-psychotic, mood stabilizing, or anti-depressant medications within the past 12 months

*Person must be in or transitioning to an independent living situation if under 21 years old, and there must be a medical necessity if under 18 years old.

THERAPY, CRISIS INTERVENTION, AND LIFE-SKILLS TRAINING FOR CHILDREN – INTENSIVE IN-HOME SERVICE

 We look forward to serving youth who meet the following eligibility criteria:

Individuals must demonstrate a clinical necessity for the service arising from a severe condition due to mental, behavioral, or emotional illness that results in significant functional impairments in major life activities. Individuals must meet at least two of the following criteria on a continuing or intermittent basis:

  1. Has difficulty due to mental, behavioral, or emotional illness in establishing or maintaining normal interpersonal relationships to such a degree that they are at risk of hospitalization or out-of-home placement because of conflicts with family or community; and/or
  1. Exhibits such inappropriate behavior due to mental, behavioral, or emotional illness that repeated interventions by the mental health, social services, or judicial system are necessary; and/or
  1. Exhibits difficulty in cognitive ability due to mental, behavioral, or emotional illness such that they are unable to recognize personal danger or recognize significantly inappropriate social behavior. For example, is at risk for acting out in such a fashion that will cause harm to themselves or others.
  1. The child is at risk of out-of-home placement due to the clinical needs of the child, and either:
    • Services that are far more intensive than outpatient clinic care are required to stabilize the child in the family situation; or
    • The child’s residence, as the setting for services, is more likely to be successful than a clinic.

Exclusionary criteria include:

  • Youth who are married
  • Youth who are in active duty with any of the armed forces of the United States
  • Active psychotic behavior
  • Active substance abuse that interferes with interaction
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