Eligibility for In-home Treatment

Necessary Factors for a Child to Qualify for the
Intensive In-Home
SED (Severely Emotionally Disturbed) Program
We have immediate openings in our in-home therapy program for youth who meet these factors.
Necessary Demographic Factors
1.    Child is between ages 3 to 21.
2.    Child must have Medicaid (Straight Title-19)  insurance.  (If the child is in a Medicaid HMO,
there may be options for dis-enrollment or for HMO approval.)
Necessary Emotional-Behavioral Factors
3.  Child must have a Severe Emotional Disturbance.  (The youth meets criteria for a DSM-lV Diagnosis
such as: AD/HD, Conduct Disorder, Attachment Disorders, Substance Abuse, Psychotic Disorders, Mood Disorders, Panic Disorders, Anxiety, or Adjustment Disorders).
4.  Child has already received intervention from 2 or more providers such as: special education, mental
health services, social services, child protective services, juvenile justice, or residential treatment.
Child must also exhibit:
1. Impairment in two of the following areas: family relationships, peer relations, school, self care,
or impulse control OR
1. Suicidal/homicidal ideation or impulses, frequent or severe aggressive behavior or violence, or
a psychotic episode.
Necessary Commitment and Motivational Factors
1. Family will accept intense intervention in the home by 1-2 therapists for 2-8 hours per week.
2. Family will exhibit motivation, commitment, and follow-through while working with the treatment team
over a 3 to l2 month period.
7.   Family will be reliable for meetings, to assist in getting “Health Check,” and psychiatric assessments
as deemed necessary.
1. Parent or legal guardian is available to sign a “Consent for Treatment” and  “Release of Information”
form when the child is accepted into the program.
Other Important Information
• Children in foster care are welcome in the program.
• If the family has more than one child who meets criteria for participation in this program, additional hours
of service can often be provided for the family, up to 16 hours per week.
• Family participation is vital to the success of the in-home SED program.
Do you or someone you know have a child who meets these factors?
If there is strong interest in the program, click here to download form .
sheet to Jeremy Burtch at (608) 835-5010 or call (608) 835-5050 x 4.

Insurance eligibility

  • Approval/authorization by the insurance company is necessary prior to services.  Please note: some Medicaid HMO’s, and most private insurance companies are difficult to obtain approval for in-home services.  Please contact your insurance company to check eligibility and service authorizations.  Contact Jeremy at jeremy@oregonmentalhealthservices.com with additional questions that pertain these service authorizations.

Eligibility requirements for Medicaid/T-19 In-home psychotherapy

  • Child is between ages 3 to 21.
  • Child must have Medicaid (Straight Title-19) insurance.  (If the child is in a Medicaid HMO, there may be options for HMO approval-see below).
  • Child must have a Severe Emotional Disturbance.  The youth meets criteria for a DSM-V Diagnosis such as: ADHD, Conduct Disorder, Attachment Disorders, Psychotic Disorders, Mood Disorders, Panic Disorders, Anxiety, or Adjustment Disorders.
  • Child has already received intervention from 2 or more providers such as: special education, mental health services, social services, child protective services, or juvenile justice.
  • Child has had a psychiatric evaluation in the past 6 months, or will have a psychiatric evaluation in the next 60 days to determine differential diagnosis and appropriateness for In-Home psychotherapy.

Child must also exhibit:

  • Impairment in two of the following areas: family relationships, peer relations, school, self care, or impulse control OR
  • Suicidal/homicidal ideations or impulses, frequent or severe aggressive behavior or violence, or a psychotic episode.

Necessary Commitment and Motivational Factors

  1. Family will accept intense intervention in the home by 1-2 therapists for 2-8 hours per week.
  2. Family will exhibit motivation, commitment, and follow-through while working with the treatment team over a 3 to 12 month period.
  3. Family will be reliable for meetings, to assist in getting “Health Check,” “In-home Prescription,” and psychiatric assessments as deemed necessary.
  4. Parent or legal guardian is available to sign a “Client Rights and Informed Consent” form and  “Authorization to Release Information” form when the child is accepted into the program.

Other Important Information

  • Children in foster care are welcome in the program.
  • If the family has more than one child who meets criteria for participation in the program, additional hours of service can often be provided for the family, up to 16 hours per week.
  • Family participation is vital to the success of the in-home SED program.
  • A psychiatric evaluation needs to be done by a psychiatrist, psychologist, or APNP in the HMO network to help determine if medication management is needed or is being utilized most effectively.  Please note a primary doctor is not eligible to complete this evaluation, even if they are prescribing the psychotropic medications.
  • The health check, prescription, and psychiatric evaluation are required by Medicaid for all children that are currently enrolled in Medicaid or a Medicaid HMO.

Child in a Medicaid HMO

  • Prior to in-home services starting, the guardian must contact the Medicaid HMO to identify if they provide authorization for in-home services.  If the HMO states in-home therapy is approved, OMHS will need to confirm this prior to services starting.  This process takes time and is not guaranteed.  It is strongly encouraged that your child continue to see his/her outpatient therapist while this confirmation is in progress.

Do you or someone you know have a child who meets these factors?

If there is strong interest in the program, download, complete and fax (do not email) the In-home referral form (PDF) to (608)-835-5010. If you have questions about the program, eligibility or HMO questions please email Jeremy  at jeremy@oregonmentalhealthservices.com.