Section 354.2651 - Eligible Individuals(a) Mental health targeted case management is available to a child or youth who: (1) is a resident of the State of Texas;(2) is a recipient of the Texas Medicaid Program; and(3) has a diagnosis or diagnoses of mental illness or serious emotional disturbance as defined in the latest edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, not including a single diagnosis of an intellectual or developmental disability or a substance use disorder and who: (A) has been determined via the uniform assessment process as described in § 354.2607 of this subchapter (relating to Assessment and Service Authorization) to have serious functional impairments and is in need of mental health targeted case management services;(B) is at risk of disruption of a preferred living or child-care environment due to psychiatric symptoms; or(C) is enrolled in a school system's special education program because of serious emotional disturbance.(b) Mental health targeted case management is available to an adult who: (1) is a resident of the State of Texas;(2) is a recipient of the Texas Medicaid Program;(3) has a diagnosis or diagnoses of mental illness as defined in the latest edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, not including a single diagnosis of an intellectual or developmental disability, dementia, or a substance use disorder; and(4) who has been determined via an assessment process based on § 354.2607 of this subchapter to have serious functional impairments and is in need of mental health targeted case management services.(c) An individual is not eligible for Medicaid-funded mental health targeted case management if the individual is:(1) an inmate of a public institution, as defined in RSA 435.1009;(2) a resident of an intermediate care facility for individuals with an intellectual disability or related conditions as described in RSA 440.150;(3) a resident of an IMD;(4) a patient of a general medical hospital; or(5) receiving psychosocial rehabilitative services, a component of mental health rehabilitative services.1 Tex. Admin. Code § 354.2651
Adopted by Texas Register, Volume 43, Number 41, October 12, 2018, TexReg 6823, eff. 10/17/2018