meeting various problems-in-living. Children and adolescents under the age of 18 may be evaluated on the , or C-GAS. 97.02-7 Medical Eligibility Criteria for Appendix D Child Care Facility Services are four models of PNMI services for Appendix D Child Care Facilities: Mental Retardation and Pervasive Developmental Disorder (PDD) Conditions: Child and Adolescent Intensive Temporary Behavioral Health Treatment in a Residential Setting There are two levels of PNMI services for children with mental retardation and/or PDD and other symptoms requiring this intensity of service. A child is eligible for only one level of service at a time. Initial prior authorization will not be given for more than thirty days at a time and continuing stay will be assessed at a minimum of every ninety days thereafter. All of the following criteria set forth below must be met, in addition to criteria for either Level I or Level II services, as detailed below. The child must have: An Axis I or II diagnosis from the most current version of the DSM, and A disorder that has lasted for at least six (6) months or is expected to last for at least one (1) year in the future, and A current need for therapeutic treatment or availability of a therapeutic on-site staff response on a twenty-four hour basis, and A disorder that is amenable to treatment in a residential setting, and even with intensive community intervention, including services and supports, there is significant potential that the child will be hospitalized, or there 97.02 ELIGIBILITY FOR CARE (cont.) is a clear indication that the child’s condition would significantly deteriorate and would require a higher model of service than can be provided in the home and community.
meeting various problems-in-living. Children and adolescents under the age of 18 may be evaluated on the , or C-GAS. 97.02-7 Medical Eligibility Criteria for Appendix D Child Care Facility Services are four models of PNMI services for Appendix D Child Care Facilities: Mental Retardation and Pervasive Developmental Disorder (PDD) Conditions: Child and Adolescent Intensive Temporary Behavioral Health Treatment in a Residential Setting There are two levels of PNMI services for children with mental retardation and/or PDD and other symptoms requiring this intensity of service. A child is eligible for only one level of service at a time. Initial prior authorization will not be given for more than thirty days at a time and continuing stay will be assessed at a minimum of every ninety days thereafter. All of the following criteria set forth below must be met, in addition to criteria for either Level I or Level II services, as detailed below. The child must have: An Axis I or II diagnosis from the most current version of the DSM, and A disorder that has lasted for at least six (6) months or is expected to last for at least one (1) year in the future, and A current need for therapeutic treatment or availability of a therapeutic on-site staff response on a twenty-four hour basis, and A disorder that is amenable to treatment in a residential setting, and even with intensive community intervention, including services and supports, there is significant potential that the child will be hospitalized, or there 97.02 ELIGIBILITY FOR CARE (cont.) is a clear indication that the child’s condition would significantly deteriorate and would require a higher model of service than can be provided in the home and community.
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