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BEM 172 2 of 4 CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE (SED) WAIVER BPB 2024-023 10-1-2024
BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES
• It is appropriate to provide such care for the child in the community; and • The average estimated cost to Medicaid of caring for the child in the community does not exceed the average estimated cost to Medicaid for the child’s care in the state psychiatric hospital. Mental Health Services to Children and Families within BCCHPS is responsible for the following at application and medical review: • Obtaining and reviewing clinical evidence of the child’s serious emotional disturbance and functional limitations from the local CMHSP, and • Certifying disability on the DHS-49-A, Medical-Social Eligibility Certification. The Behavioral and Physical Health and Aging Services Administration (BPHASA) certifies on the MSA-1785, Policy Decision, that the requirements in BCCHPS Responsibilities in this item are met. If the child is not receiving MA, BPHASA will send the family: • A copy of the MSA-1785, and • A DCH- 1426, Assistance Application, with the address of the local office to mail the completed application. Communication to the Local Office BPHASA will send the MSA-1785 and the DHS-49-A to the local MDHHS and CMHSP offices whether or not a child is an MA recipient. BPHASA will send a letter of termination when a child is no longer eligible for this category. Pursue eligibility for other MA categories when a child is no longer eligible for the waiver. Local Office Responsibilities Do not authorize MA under this category without a MSA-1785 and DHS-49-A authorizing MA in this category. Use this cate- gory when the child is not an SSI or FIP recipient. Use this category before using a Group 2 category. Treat the receipt of the MSA-1785 as a request for assistance if it is received for a child who is not an MA applicant or recipient.