Intensive Customized Care Coordination (IC3)

Wraparound is a strength-based approach that helps families who have children with behavioral health needs function more effectively in the community. WinGeorgia CME assists each family in building a Wraparound team comprised of people who are most important to them. The team focuses on finding services unique to each child’s needs. Based on family strengths and culture, a Care Coordinator works with the family to develop an individualized plan to meet goals identified by the family. Family input is very important to this process. No plan can work unless it truly meets a family’s specific needs. Parental investment is critical to family success.

While WinGeorgia CME offers a basic list of criteria regarding eligibility for IC3 (see below), each youth’s circumstances are different. In order to clearly determine if a youth or young adult may be eligible, please complete the Pre-Referral Questionnaire.

• Ages six (6) to twenty-one (21)
• Behavioral health diagnosis, such as ADHD, Depression, Bipolar Disorder, etc. (must be main diagnosis)
• Difficulty at home, school, work, or in the community with DFCS, DJJ, Juvenile Court, Truancy Treatment, CHINS, or LIPT involvement
  AND
• Risk of suicide or harm to self or others with high risk behaviors
  OR
• Recent hospitalization
• Difficulty carrying out wellness activities (i.e. taking medications, following treatment plan) or behaviors which negatively effect their well-being.

MFP (Money Follows the Person) is a waiver designed to provide psychiatric residential treatment facility (PRTF) -level community-based services in the home through an individualized Wraparound planning process. A Care Management Entity (CME) of your choice will help you prioritize your family’s needs through a child and family team process designed to build on your family strengths. These strengths are used to meet developed goals and objectives while building on your already existing natural and community support system. This process is an alternative to PRTF to build supports in the family’s home and community so the family can remain together.

MFP serves children and youth (ages 5-17) and young adults (ages 18 – 21) who have serious emotional and behavioral health needs. Youth must have a primary diagnosis of mental illness as identified in the DSM-IV in order to qualify.

Additionally, the child, youth or youth adult must meet the following requirements:

• has been in a Psychiatric Residential Treatment Facility (PRTF) for at least 90 days
• meets medical necessity requirements for continued stay in PRTF

MFP applications may only be submitted by PRTF staff and Tier 1, Tier 2, or Tier 2+ behavioral health providers (Core Provider).

To refer a child/youth, request that an MFP application be submitted before a discharge date is set. If the application is filed after the discharge date is set, the approval process could lapse beyond the discharge date, causing the child/youth to be ineligible for the program.

If the child/youth is discharged before MFP is approved, a direct referral for CBAY services can be made to the CME through the Referral menu at the top of the page.

Providers may access the documents required to submit an application by clicking here.

There may still be time to submit an application.  Please see the information below to determine the best option:

Prior to discharge

If a discharge date has been set, you may still request an MFP application be submitted. See “How do I refer a child/youth for MFP?”

After discharge

If the child or young adult is discharged before the application is submitted or approved, you will need to submit a referral directly to a CME (Care Management Entity) for CBAY supports.

Click here to submit a referral if the child or young adult has been discharged.

Yes, as part of enrolling in CBAY services, each participant signs a document indicating Freedom of Choice. The youth and family can choose to receive PRTF services, discharge and go home, or be enrolled in CBAY. Although this signature documents the choice of community services, it also documents that the participant has choice of providers, both at services onset and as long as enrolled in program.

In this process, the intent is to inform and to document that the participant and his or her legal representative will be:

1. informed of alternatives and services available under the MFP
2. given the choice of either PRTF or Home and Community-Based Services
3. aware a signed document is on file indicating Freedom of Choice and for witnessing the signature(s).

Youth and young adults enrolled through MFP will receive a mix of services based on their needs.  These services may include:

• Participant Services of Care Management
• Respite
• Supported Employment
• Community Transition
• Expressive Clinical and Clinical Consultative Services
• Customized Goods and Services
• Family Peer Support
• Behavioral Assistance
• Youth Peer Support Services
• Transportation and Financial Support Services

There are two ways you can make a referral for a child/youth who is enrolled with Amerigroup GF 360°:

1. Make a direct referral to LM CME through the “Referrals” menu above
2. Request CME services through the child/youth’s Amerigroup GF 360° Care Coordinator

Once the child/youth is referred, the Amerigroup GF 360° will review the case to determine if the child’s medical history meets Amerigroup’s criteria for authorization of services.