For IIH services, in Chapter IV on page 34 when referencing Individual and family counseling is a required component… please add this can be achieved by coordinating with an outpatient provider if the IIH provider is a QMHP-C (as documented in Chapter IV, page 37).

For IIH services, in Chapter IV on page 30 under Service Definition the following is included:  “IIH services are designed to promote benefits of psychoeducation in the home setting OF AN INDIVIDUAL WHO IS AT RISK OF BEING MOVED INTO AN OUT-OF-HOME PLACEMENT …… due to a documented medical need of the individual”.  The section in the current manual that defines “at risk of being moved into an out-of-home placement” is going to be removed in the proposed changes.  The definition for “out of home placement” in Chapter IV on pages 6 – 7 does not include how to define / justify / prove / document the individual ‘is at-risk of being moved into an out-of-home placement in one of the mentioned places.  Do providers use their definition of ‘at risk’; as long as the reasons are explained using Medical Necessity Criteria with clear documentation that medical necessity is met?