DivisionMedicaid Prior Authorized Levels of Care

1
Division/Medicaid Prior Authorized Levels of Care

• SD Treatment Network Meeting
• Cedar Shore, Chamberlain
• January 27-28, 2009

2
Adolescent Services

• Level III.7 Inpatient Treatment
• Aberdeen Area Youth Regional Treatment Center
  (Chief Gall)
• Human Services Center
• Keystone
• Our Home Rediscovery
• Timberline
• Wellsprings
• Volunteers of America - Dakotas

3
Adolescent Services

• Level III.7 Short Term Relapse Program
• Level III.1 Low Intensity services for pregnant
  adolescents or adolescents with dependent
  children
• Level II.5 Day Treatment
• Level II.1 Intensive Outpatient Treatment

4
Adolescent Services

• Level III.7 Short Term Relapse Program
• Our Home Rediscovery
• Timberline
• Wellsprings

5
Adolescent Services

• Level III.1 Low Intensity services for pregnant
  adolescents or adolescents with dependent
  children
• Volunteers of America Dakotas New Start

6
Adolescent Services

• Level II.5 Day Treatment
• Martin Addiction Recovery Center
• Wellsprings
• Volunteers of America Dakotas

7
Adolescent Services

• Level II.1 Intensive Outpatient Treatment
• Bartels Counseling Services
• Capital Area Counseling Services
• Stepping Stones
• Dakotah Pride
• Keystone Outreach
• Life Light Counseling
• Main Gate Counseling
• Martin Addiction Recovery Center
• Southern Hills Alcohol Drug Programs
• Volunteers of America Dakotas
• Wellsprings/Soaring Eagle

8
Pregnant Women

• Inpatient Treatment
• Day Treatment
• Intensive Outpatient Treatment
• Long term low intensity services for pregnant
  women/women with dependent children

9
Adult Contract Division approved levels of care

• Level III.7 Inpatient Treatment
• Keystone
• Human Services Center
• Black Hills Recovery Center
• Dakotah Pride
• Level II.5 Day Treatment
• Worthmore
• Addiction Family Resources (Division approval is
  not necessary for this program).

10
Adult Contract Division approved levels of care

• Slip/Slot Services (II.1 III.1 Combined)
• Carroll Institute
• Glory House
• Pennington County Friendship House
• Serenity Hills
• Stepping Stones
• III.1 Services
• Serenity Hills Dual Diagnosis Program (Approved
  by both Division of MH ADA)

11
State Employees

• The Means Form 101 and Consent for Information
  Disclosure, as well as the TNA must be submitted
  to the Division for all services rendered to
  State Employees or their dependents.
• The Client Information Screen as well as the
  Admission Screen in STARS MUST specify State
  Employee Ins in the ADA Source of Payment box.

12
Methamphetamine Specific Programs

• All requests for approval to the Methamphetamine
  Specialized programs must be sent to Cindy Ryan.
• Level III.7 at Keystone
• Level II.5 at City/County Alcohol Drug Programs
  (Friendship House)