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2017-55: Specialized Behavioral Health Services Available To Nursing Facility Residents

Date: 10/24/17

Effective Dec. 1, 2015, with the integration of primary and behavioral health care services, individuals residing in nursing facilities became eligible to receive Mental Health Rehabilitation Services. Behavioral health services for Medicaid eligible nursing home residents are provided through one of the five Healthy Louisiana Plans, including Louisiana Healthcare Connections.

Effective Dec. 1, 2015, the Managed Care Organizations (MCOs) also began conducting face-to-face evaluations with the Preadmission Screening and Resident Review (PASRR) process. The MCOs will also provide Case Management and develop Plans of Care for certain Nursing Facility residents. 

Medicaid recipients living in nursing homes may receive the following mental health and substance use services if medically necessary:

  • Inpatient psychiatric hospital services
  • Outpatient mental health treatments (individual, family and group)
  • Substance use treatments
    • Outpatient treatment
    • Intensive Outpatient (IOP) treatment
    • Detox
    • Ambulatory – which is outpatient but medically monitored
    • Residential – which is inpatient and medically driven
    • Residential treatment
  • Psychiatric medication management
  • Mental Health Rehabilitation (MHR) services
    • Psychosocial Rehabilitation (PSR) – skill development:  social and interpersonal skills, daily living skills, coping strategies and effective functioning. These services may be provided individually or in a group setting.
    • Crisis Intervention (CI) – services provided to someone experiencing a psychiatric crisis. CI is designed to avoid more restrictive levels of treatment such as inpatient psychiatric care. CI can occur in a variety of locations.
    • Community Psychiatric Support and Treatment (CPST) - individual supportive counseling. The goal is to minimize symptoms, disturbances, stressors which interfere with the individual’s daily living, personal recovery, family and/or interpersonal relationships and community integration. 
  • Assertive Community Treatment (ACT) – therapeutic interventions provided by an interdisciplinary team. This treatment is designed to increase ability to cope and enhance highest level of functioning in the community.