Question 1

Child and Adolescent Day Treatment

Accepted Answer

This service is designed to serve children who, as a result of their mental health or substance use disorder treatment needs, are unable to benefit from participation in academic or vocational services at a developmentally appropriate level in a traditional school or work setting.

These interventions are designed to reduce symptoms, improve behavioral functioning, increase the individual’s ability to cope with and relate to others, promote recovery, and enhance the individual’s capacity to function in an educational setting or to be maintained in community-based services. It is available for children 5 through 17 years of age.

Question 2

Outpatient Services

Accepted Answer

Outpatient services are provided to individuals of all ages and disabilities, families, or groups in a non-hospital setting through short visits for the purpose of treatment, habilitation, or rehabilitation.

Question 3

Targeted Case Management

Accepted Answer

Case Management is a service that assists individuals in gaining access to needed state plan services as well as needed medical, social, educational, and other services. It assists with linking, assessing, referral, and coordinating needed services on behalf of the individual.

Question 4

Peer Support Services

Accepted Answer

Peer Support Services (PSS) are an evidence-based mental health model of care that provides
community-based recovery services directly to a Medicaid-eligible adult beneficiary diagnosed
with a mental health or substance use disorder. PSS provides structured, scheduled services that
promote recovery, self-determination, self-advocacy, engagement in self-care and wellness and
enhancement of community living skills of beneficiaries.

Question 5

Substance Abuse Intensive Outpatient Program

Accepted Answer

SA Intensive Outpatient Program (SAIOP) means structured individual and group addiction activities and services that are provided at an outpatient program designed to assist adult and adolescent recipients to begin recovery and learn skills for recovery maintenance.

1. Individual counseling and support
2. Group counseling and support
3. Family counseling, training, or support
4. Biochemical assays to identify recent drug use (e.g. urine drug screens)
5. Strategies for relapse prevention to include community and social support systems in treatment;
6. Life skills
7. Crisis contingency planning
8. Disease Management
9. Treatment support activities that have been adapted or specifically designed for persons with physical disabilities, or persons with co-occurring disorders of mental illness and substance abuse/dependence or mental retardation/developmental disability and substance abuse/dependence.

Question 6

Substance Abuse Comprehensive Outpatient Treatment

Accepted Answer

SACOT Program is a service emphasizing a reduction in use and abuse of substances and/or continued abstinence, the negative consequences of substance abuse, development of social support network and necessary lifestyle changes, educational skills, vocational skills leading to work activity by reducing substance abuse as a barrier to employment, social and interpersonal skills, improved family functioning, the understanding of the addictive disease, and the continued commitment to a recovery and maintenance program. These services are provided during day and evening hours to enable individuals to maintain residence in their community, continue to work or go to school and be a part of their family life.

Question 7

Medical Screenings and Prevention

Accepted Answer

This service is provided in the office or through telehealth. The office hours are 8:30 am to 4:30 pm.  Medical screening and preventive services can be provided Monday through Friday via consultation or on already scheduled days throughout the month. The service is provided by Family Nurse Practitioner. Medical screenings and screenings such as Diabetes, High Blood Pressure, High Cholesterol checks, etc. can be done at our location.  If further health treatment is needed, individuals will be referred to a Primary Care Provider.

Question 8

Intensive In-Home Services

Accepted Answer

This is a time-limited intensive family preservation intervention, led by a Licensed Therapist, intended to stabilize the living arrangement, promote reunification or prevent the utilization of out-of-home therapeutic resources (i.e., psychiatric hospital, therapeutic foster care, residential treatment facility) for the identified youth through the age of 20. These services are delivered primarily to children in their family’s home with a family focus to:

1. Defuse the current crisis, evaluate its nature, and intervene to reduce the likelihood of a recurrence
2. Ensure linkage to needed community services and resources
3. Provide self-help and living skills training for youth
4. Provide parenting skills training to help the family build skills for coping with the youth’s disorder
5. Monitor and manage the presenting psychiatric and/or addiction symptoms
6. Work with caregivers in the implementation of home-based behavioral supports

Services may include crisis management, intensive case management, individual and/or family therapy, substance abuse intervention, skills training, and other rehabilitative supports to prevent the need for out-of-home, more restrictive services. This intervention uses a team approach designed to address the identified needs of children and adolescents who are transitioning from out-of-home placements or are at risk of out-of-home placement and need intensive interventions to remain stable in the community. This population has access to a variety of interventions 24 hours a day, 7 days a week, by staff that will maintain contact and intervenes as one organizational unit.

Question 9

Tailored Care Management

Accepted Answer

Tailored Care Management is a North Carolina Medicaid service that utilizes a team approach led by a Care Manager where the goal is to provide whole-person care management in your area. Optimal Behavioral’s Tailored Care Management program works to integrated physical health, pharmacy, care coordination and behavioral health services for members who may have significant mental health needs or severe substance use disorders.

Your supports here at Optimal Behavioral, LLC are here to listen to your individual and family needs and take action toward helping you achieve your goals. The Care Manager will develop a plan based on your needs that brings together the people that care for you – your therapist, your doctors, your family and the community services that will help you with a quality way of life.

Question 10

1915i Services

Accepted Answer

Individual and Transitional Support:
Individual and Transitional Support is a direct, one-on-one service provided to a beneficiary aged 16 and older with a Serious Emotional Disturbance (SED), Serious Mental Illness (SMI), Severe and Persistent Mental Illness (SPMI) or a severe substance use disorder (SUD) diagnosis. This service provides structured, scheduled interventions to improve a beneficiary’s ability to manage Instrumental Activities of Daily Living (IADL) and promote independent functioning in the community and recovery. Activities are provided in partnership with a beneficiary to develop skills needed to: a. engage in their self-directed recovery process; b. obtain, maintain employment; c. access transportation; d. obtain, maintain housing; e. improve, maintain financial responsibility; or f. continue their education.

Qualifying Population and Age:
SED- ages 16-21 
SMI-ages 19+ 
SUD all ages

Respite:
Respite services provide periodic support and temporary relief to the primary caregiver(s) from the responsibility and stress of caring for a: a. child or adolescent beneficiary ages 3-21 with a diagnosis of a Serious Emotional Disturbance (SED) or substance use disorder (SUD), or b. child, adolescent, or adult beneficiary with an Intellectual or Developmental Disability (I/DD) Traumatic Brain Injury (TBI) ages 3 or older. This service enables the primary caregiver(s) to participate in planned or emergency events, and to have planned breaks in caregiving.

Qualifying Population and Age:
I/DD-all ages 
 SED-ages 3-20 
 SUD-ages 3-20

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