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STATE CHILD HEALTH PLAN UNDER TITLE XXI OF THE SOCIAL SECURITY ACT

STATE: Virginia Page 6-39

Effective Date: 07/01/05

39 Approval Date: _____________/06 condition. The yearly limit for mental health support services is 372 units.

8. Intensive Community Treatment- Medical psychotherapy, psychiatric assessment, medication management, and case management activities offered to outpatients outside the clinic, hospital, or office setting for individuals who are best served in the community. The annual unit limit shall be 130 units.

9. Case Management - Case management services for youth at risk of serious emotional disturbance and who meet the definition of Seriously Emotionally Disturbed. Case management services assist youth at risk of serious emotional disturbance and with a diagnosis of Serious Emotional Disturbance in accessing needed medical, psychiatric, social, educational, vocational, and other supports essential to meeting basic needs. Services to be provided include: Assessment and planning, linking the individual directly to services and supports, assisting the individual directly for the purpose of locating, developing or obtaining needed service and resources, coordinating services and service planning, enhancing community integration, making collateral contacts, follow up and monitoring, and education and counseling. 6.2.12.A ⌧ Durable medical equipment and other medically-related or remedial devices (such as prosthetic devices, implants, eyeglasses, hearing aids, dental devices, and adaptive devices) (Section 2110(a)(12)) Prosthetic devices for the replacement of missing arms, legs and breasts and the provision of any internal (implant) body part shall be covered. Prosthetic devices (artificial arms and legs, and their necessary supportive attachments; implants and breasts) are provided when prescribed by a physician or other licensed practitioner of the healing arts within the scope of their professional license. This service when provided by an authorized vendor, must be medically necessary and preauthorized for the minimum applicable component necessary for the activities of daily living.

6.2.13.A ⌧ Disposable medical supplies (Section 2110(a)(13))

Medical supplies, equipment and appliances suitable for use in the home. All medically necessary medical supplies, equipment, and appliances are covered for recipients. Unusual amounts, types and duration of usage must be authorized by DMAS. When cost-effective, payment may be made for rental of the equipment in lieu of purchase. Prosthetics which are preauthorized shall be covered. Supplies, equipment that are not covered are: space conditioning equipment, equipment and supplies for any hospital or nursing facility resident, except for ventilators and associated supplies for nursing facility residents; furniture or