Children with Serious Emotional Disturbances Waiver

 

Waiver for Children with Serious Emotional Disturbance (SEDW)

The Michigan Department of Health and Human Services (MDHHS) received approval from the Centers for Medicare and Medicaid Services (CMS) for the Children's Home and Community-Based Services Waiver for Children with Serious Emotional Disturbance (SEDW), which began in October 2005. The SEDW is currently available in a limited number of counties and Community Mental Health Services Programs (CMHSPs).

The Children's SEDW provides services that are enhancements or additions to Medicaid State Plan coverage for children through age 20 with SED. The MDHHS operates the SEDW through contracts with the CMHSPs. The SEDW is a fee-for-service program administered by the CMHSP in partnership with other community agencies.  The MDHHS serves children in foster care in the participating counties listed below.

Key Provisions

The SEDW enables Medicaid to fund necessary home and community-based services for children with serious emotional disturbance who meet the criteria for admission to the state inpatient psychiatric hospital (Hawthorn Center) and are at risk of hospitalization without waiver services. The CMHSP is responsible for assessment of potential waiver candidates.

Application for the SEDW is made through the CMHSP.  The Wraparound Facilitator, the child and his/her family and friends, and other professional members of the planning team work together to identify the child/family's strengths, needs, interventions and outcomes following the Wraparound Practice Model.  The Wraparound Individual Plan of Service (IPOS) identifies all the services and supports necessary to meet the needs and outcomes.

Eligibility

To be eligible for this waiver, the child must:

•     Live in a participating county; OR

•     Live in foster care in a non-participating county pursuant to placement by MDHS or the court of a  participating county, with SEDW oversight by a participating county's CMHSP; AND

•     Reside with the birth or adoptive family or have a plan to return to the birth or adoptive home; OR

•     Reside with a legal guardian; OR

•     Reside in a foster home with a permanency plan; OR

•     Be age 18, 19 or 20 and live independently with supports; AND

•     Meet current MDHHS criteria for the State psychiatric hospital for children, as defined in the Michigan  Medicaid Provider Manual; AND

•     Meet Medicaid eligibility criteria and become a Medicaid beneficiary; AND

•     Demonstrate serious functional limitations that impair their ability to function in the community.  As appropriate for age, functional limitation will be identified using the Child and Adolescent Functional Assessment Scale (CAFAS®) or the Preschool and Early Childhood Functional Assessment Scale (PECFAS®):

o   CAFAS® score of 90 or greater for children age 7 to 12; OR

o   CAFAS® score of 120 for greater for children age 13 to 18; OR

o   For children age 3 to 7: elevated PECFAS® subscale scores in at least one of these areas: self-harmful behaviors, mood/emotions, thinking/communicating or behavior towards others; AND

•    Be under the age of 18 when approved for the waiver.  If a child on the SEDW turns 18, continues to meet all non-age-related eligibility criteria and continues to need waiver services, the child can remain on the waiver up to his/her 21st birthday.

Coverage Area

The counties and CMHSPs currently approved are:

  • Allegan County CMH Services (Allegan County)
  • Bay-Arenac Behavior Health (Bay and Arenac Counties)
  • Berrien Mental Health Authority (Berrien County)
  • CMH for Central Michigan (comprised of Clare, Gladwin, Isabella, Mecosta, Midland and Osceola)
  • CMH Authority of Clinton-Eaton-Ingham Counties (Clinton, Eaton and Ingham)
  • Detroit-Wayne County CMH Agency ((Wayne County)
  • Genesee County CMH Services (Genesee County)
  • Gratiot County CMH Services (Gratiot County)
  • Kalamazoo CMH & Substance Abuse Services (Kalamazoo County)
  • Lifeways (Jackson and Hillsdale Counties)
  • Livingston County CMH Authority (Livingston County)
  • Macomb County CMH Services (Macomb County)
  • CMH Services of Muskegon (Muskegon County)
  • Network 180 (Kent County)
  • Newaygo County Mental Health Center (Newaygo County)
  • Northern Lakes CMH Authority (Grand Traverse, Leelanau, Wexford and Roscommon Counties)
  • Oakland County CMH Authority (Oakland County)
  • Pathways (Marquette County only)
  • St. Clair County Mental Health Authority (St. Clair County)
  • Saginaw County CMH Authority (Saginaw County)
  • Summit Pointe (Calhoun County)
  • Van Buren CMH Authority (Van Buren County)
  • Washtenaw Community Health Organization (Washtenaw County)
  • West Michigan Community Mental Health System, (Oceana County only)
  • Woodlands Behavioral Health Network (Cass County)

If you suspect or are aware of the abuse, neglect or exploitation of a recipient of public mental health services in Michigan, use the following link to assist you in reporting the information, or call the MDCH-ORR

Hotline:             1-800-854-9090.

http://www.michigan.gov/mdch/0,4612,7-132-2941_4868_4901---,00.html.

Contact:

Audrey Craft, Director of Children's Home and Community-Based Waivers, e-mail:  crafta@michigan.gov,

517-241-5757.

Angelo Powell, Services to Children and Families Partnership Analyst, e-mail:  powella8@michigan.gov,

517-373-2067