CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Clinical Considerations
Community Treatment Supports
Continuity of
Care Team
(COC)*
Intense, short term and assertive case management
available 24 hours per day. Services include outreach,
engagement, assessment, linkages to community
resources, intervention and advocacy
For members frequently using inpatient levels of
care who do not have active case management
services. Works to connect members to
appropriate services to prevent unnecessary
hospitalizations.
COC will work with members who are not yet CBH
eligible or who have lost eligibility and will assist
with the enrollment process.
COC is able to work with members with complex
medical needs and ensure adequate follow up
with physical health appointments.
Rapid Response
Team (RRT)*
RRT provides short-term outreach services to adult
consumers without case management services who have
been identified as having been involuntarily committed 2
or more times in a 12-month period; or who have been
seen frequently in Crisis Response Centers, inpatient
units, or Mental Health Court; or who have had multiple
contacts with the Mental Health Delegate.
1 Updated April 2015
Upon meeting with the individual, RRT will discuss
available treatment options and psychosocial
supports and make referrals as necessary. This
may include the completion of a referral for
Targeted Case Management.
Designed to be initiated by the Crisis Response
Centers in lieu of hospitalization.
Specialty teams and
Evidence Based
Practices** (available at
some providers)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Clinical Considerations
Certified Peer Specialists offer peer support, which is a
specialized therapeutic interaction, conducted by self
identified current or former members of behavioral health
services who are trained and certified to offer support and
assistance. They help others in their recovery; attain and
manage their own home in the community; and pursue
employment/and or educational goals. CPS provides
opportunities for self-directed services and advocacy;
teach and support skills necessary to facilitate the recovery
process.
CPS is a Core Service for individuals in Permanent
Supportive Housing
Certified Peer
Specialist*
The primary objectives of the Peer Support
Services are:
Provide opportunities for individuals receiving
services to direct their own recovery and advocacy
Teach and support acquisition and utilization of the
skills needed to facilitate an individual’s recovery
Promote the knowledge of available service
options and choices
Facilitate the development of a sense of wellness
and self worth
Peer Support services cannot exceed 20 hours per
week of service hours. CPS must work at the
convenient of the individual receiving services; and
a substantial amount of hours must be outside of
normal business hours
2 Updated April 2015
Specialty teams and
Evidence Based
Practices** (available at
some providers)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Mobile Psychiatric Rehabilitation Services (MPRS) assist
individuals with functional impairments resulting from
mental illness to develop, enhance, and/or retain skills and
competencies specific to community living so that
individual can manage their own home and achieve
community integration. The responsibilities of MPR staff
include providing in vivo skill development and support in
areas of independent living, household management, MH
and D&A symptom management and relapse prevention,
social skills, education and employment goal setting
Mobile
Psychiatric
Rehabilitation
(MPRS)*
Frequency: MPRS must work at the convenience of the
individual receiving services; and a substantial amount of
hours must be outside of normal business hours. Face to
face interactions must occur, at a minimum on a weekly
basis between MPRS staff and individuals participating in
services, unless otherwise requested by the individual.
3 Updated April 2015
Clinical Considerations
MPRS is a Core Service for individuals in
Permanent Supportive Housing
The primary objectives of MPRS are composed of
three strategies:
Help individuals identify goals
Help individuals develop necessary supports to
maintain goals
Help individuals plan strategies and acquire
necessary skills to reach and maintain the desired
goals
Specialty teams and
Evidence Based
Practices** (available at
some providers)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Clinical Considerations
Specialty teams and
Evidence Based
Practices** (available at
some providers)
Community Treatment Supports- Targeted Case Management
Resource
Coordination*
Intensive Case
Management*
A community based, short term service for persons with
major mental illness who may have also have minor
substance abuse issues and mild to moderate difficulty
accessing mental health treatment, social, and job-related
daily living skills.
For individuals with history of unsuccessful
outpatient treatment who are currently in the
shelter system or who are defined as “street
homeless.”
A community based service which is designed to assist
members to gain access to community agencies, services
and professionals whose functions are to provide the
support, training and assistance required for a stable, safe
and healthy community life.
For individuals with history of unsuccessful
outpatient treatment. Eligibility is based on MH
diagnosis, MH treatment history and Global Level
of Functioning.
4 Updated April 2015
Eligibility is based on MH diagnosis, MH treatment
history and Global Level of Functioning.
Serious Mental Health Diagnosis.
Specialty Teams:
RHD/Connections—
individuals residing in
shelters; RHD/FaSST—
families residing in shelters;
Hall Mercer/Prevention and
Recovery Services (PARS)—
90 day term of service
Specialty Teams: “Street
Homeless” and Deaf and
Hard of Hearing
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Blended Case
Management*
Elements of Treatment
A community based service which is designed to assist
members to gain access to community agencies, services
and professionals whose functions are to provide the
support, training and assistance required for a stable, safe
and healthy community life.
These programs work in a team model and have the ability
to adjust the intensity of the services provided to meet the
individual needs of the client without changing service
providers.
A community based service which is designed to assist
members to gain access to community agencies, services
and professionals whose functions are to provide the
support, training and assistance required for a stable, safe
and healthy community life.
Non-Fidelity
Assertive
Community
Treatment (ACT)*
These programs are enhanced with a full time Case
Manager, Nurse, Psychiatrist, Drug and Alcohol Specialist
5 Updated April 2015
Clinical Considerations
For individuals with history of unsuccessful
outpatient treatment. Eligibility is based on MH
diagnosis, MH treatment history and Global Level
of Functioning.
Specialty teams and
Evidence Based
Practices** (available at
some providers)
Specialty Teams: Forensic;
Spanish; Russian; Southeast
Asian; Young Adult
BCM is designed to support access and
coordination of services for individuals with
frequent Crisis Response Center visits and Acute
Inpatient Admissions.
For individuals with history of unsuccessful
outpatient treatment. Eligibility is based on MH
diagnosis, MH treatment history and Global Level
of Functioning.
Non Fidelity ACT is designed to support access
and coordination of services for individuals with
frequent Crisis Response Center visits and multiple
Acute Inpatient Admissions, and lack of success in
lower levels of Targeted Case Management.
Some teams include a supportive housing
component for individuals who meet specific
definitions of homelessness.
Specialty Teams:
Forensic; Co-occurring
Behavioral Health and
Intellectual disability; Complex
Medical Needs
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Drug and Alcohol
Intensive Case
Management*
(formerly known
as BHSI Case
Management)
Drug and Alcohol
Keys to
Recovery Case
Management*
Elements of Treatment
Case Management service dedicated to providing access
to recovery support services to individuals as they journey
through their recovery from the disease of addiction and
other life challenges with the goal of achieving and
maintaining long-term recovery. Provides ongoing needs
assessment, assists in goal planning to address any areas
of the person’s life that he or she is willing to address, help
to build and gain access to a community of resources and
recovery supports.
Clinical Considerations
Services are targeted for individuals who are
currently receiving substance abuse treatment or
who have received services within the last 12
months and are experiencing barriers that are
acting as interruptions in their recovery process
This team is based on a strengths-based and clinical
rehabilitative model to address the complex needs of those
requiring 24 hours 7 days per week case management
access.
Must have primary substance abuse challenges
and must meet ALL of the following:
Serves those with primary substance abuse challenges
who also experience complex histories of trauma, difficulty
managing daily living/social skills, on-going struggles with
active addiction and persistent interruptions in the recovery
process due to unaddressed or unmanaged mental health
challenges, lack of community supports or trusting
supportive relationships.
Unaddressed mental health symptoms and
difficulty engaging in traditional mental health
treatment
High Utilization of CRC
History of untreated abuse/trauma that interferes
with the ability to maintain recovery
The need for specialized housing as a result of
continued substance abuse
High utilization of detoxification or residential
treatment services
Co-occurring cognitive limitations or physical health
challenges
6 Updated April 2015
Specialty teams and
Evidence Based
Practices** (available at
some providers)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Clinical Considerations
Difficulty accessing recovery resources in the
community.
Requires 24 hour 7 day per week case
management support
Forensic
Intensive
Recovery Case
Management*
A prison deferral initiative that offers substance abuse
treatment to eligible individuals involved in the criminal
justice system in lieu of incarceration.
This program works with a team approach to include: Case
Manager, Probation officer, Alcohol and Drug treatment
provider, Mental Health Professional (if applicable).
7 Updated April 2015
Must have a court order from the judge sentencing
individual into FIR for Drug and Alcohol treatment.
Specialty teams and
Evidence Based
Practices** (available at
some providers)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Clinical Considerations
Assessment Services
Crisis Response Centers provide emergency assessment,
referrals and resource linkage to individuals experiencing a
behavioral health crisis. These Centers are open 24 hours
a day, 7 days a week.
To be used only during a behavioral health crisis.
Crisis Response
Centers (CRC)
23 Hour Holding
Bed*
Provides continued evaluation over an extended period of
time beyond the initial emergency psychiatric evaluation
to rule out Substance Induced Mood Disorder or
Substance Induced Psychosis and to further evaluate for
the most appropriate level of care. This assessment
takes place in a Crisis Response Center or Acute
Inpatient Setting.
8 Updated April 2015
For adults who may require a continued crisisfocused evaluation for an extended period of time
in the face of uncertainty that may include:
Resolution of acute intoxication, rapid
tranquilization to stabilize meds, intra muscular
administration of medications, de-escalation of
psychosocial crises by identifying significant
others to clarify history, assess their level of
support and safe housing, corroborate the client’s
claims, precipitating events and to help engage in
treatment, further diagnostic testing and
monitoring for the emergence of withdrawal.
Specialty teams and
Evidence Based
Practices** (available at
some providers)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Clinical Considerations
Provide substance use assessment, referrals and
resource linkage to individuals experiencing a substance
use related crisis or requiring a higher level of care.
To be used only during a substance use related
crisis when the community based provider is
unable to complete the assessment and referral or
when the member is not connected to services.
Substance
Abuse
Evaluation
Center
Comprehensive
Biopsychosocial
Evaluation/ReEvaluation
(CBE/CBR)
A complete gathering of ecological information through
client interview, discussion with family members and/or
caretakers, review of clinical records, and contact with
collaborating agencies that leads to a biopsychosocial
formulation, diagnoses, and treatment plan. Structured
tools are utilized to clarify diagnosis and behaviors
9 Updated April 2015
The CBE should consider the comprehensive
service needs of the child and family.
Specialty teams and
Evidence Based
Practices** (available at
some providers)
Specialty Services:
Psychosexual Evaluations
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Clinical Considerations
Specialty teams and
Evidence Based
Practices** (available at
some providers)
Community Based Treatment Services
Individual, Family and Group Therapy
Outpatient
Therapy
Community
Integrated
Recovery Center
(CIRC)
A variety of treatment modalities can be used. Modalities
should be tailored to the individual needs of the child and
family.
To help clients improve their quality of life, provide
opportunities for clients to explore and engage in the
community, to instill and encourage hope while helping
clients meet their goals. Common goals for CIRC
participants are living independently, obtaining employment
and/or education, engaging in spiritual activities, having
meaningful social roles, forming friendships, engaging in
leisure activities, volunteering, and participating as a
citizen.
The four key pillars are comprised of community inclusion,
recovery planning, family inclusion, and peer culture and
leadership. All programs have a strong peer culture, peerled groups, and leadership opportunities.
10 Updated April 2015
Outpatient therapy is the least restrictive
community based treatment
CIRCs strive to “meet members where they are”
and can help them manage a variety of clinical
issues (including psychosis, depression, drug &
alcohol use). CIRCs are ideal for members whose
symptoms are not acute enough for hospitalization
or acute partial but who require more support than
outpatient treatment. The focus on skill building as
well as stabilization. The most important
consideration is the member’s willingness to
engage in a treatment program and become
involved in the community.
Evidence Based Practices:
Cognitive Behavioral Therapy
(CBT), Dialectical Behavioral
Therapy (DBT), Prolonged
Exposure (PE)
Specialty Services: HIV+;
Latino Population; LGBTQI;
D&A; ID
Evidence Based Practices:
Partners for Change
Outcomes Management
System (PCOMS). Cognitive
Behavioral Therapy (CBT)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Assertive
Community
Treatment (ACT)*
Elements of Treatment
Clinical Considerations
Assertive Community Treatment is a team treatment
approach designed to provide comprehensive, communitybased psychiatric treatment, rehabilitation, and support to
persons with serious and persistent mental illness such as
schizophrenia.
Eligibility is based on MH diagnosis, MH treatment
history and Global Level of Functioning.
Among the services ACT teams provide are: case
management, initial and ongoing assessments; psychiatric
services; employment and housing assistance; family
support and education; substance abuse services; and
other services and supports critical to an individual's ability
to live successfully in the community.
ACT services are available 24 hours per
day, 365 days per year.
11 Updated April 2015
ACT is designed to support access and
coordination of services and provide treatment for
individuals with frequent Crisis Response Center
visits and multiple Acute Inpatient Admissions, and
lack of success in lower levels of treatment and
case management.
ACT is the most intensive community based
service and is designed to flexibly work with
members who have traditionally experienced
multiple acute treatment episodes and who need
extensive support to remain in the community.
ACT works as a stand-alone service and is
designed to meet an individual’s comprehensive
treatment and psychosocial needs.
Specialty teams and
Evidence Based
Practices** (available at
some providers)
ACT is an Evidence Based
Practice.
Evidence based practices
integrated within some ACT
programs: Dialectical
Behavioral Therapy (DBT),
Cognitive behavioral therapy
(CBT)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Clinical Considerations
Specialty teams and
Evidence Based
Practices** (available at
some providers)
Alcohol and Other Drug Treatment
Individual, Family and Group Therapy
Outpatient
Intensive
Outpatient
Services (IOP)
Medication
Assisted
Treatment
Programs
(MATP)
A variety of treatment modalities can be used. Modalities
should be tailored to the individual needs of the individual
and target substance abuse, and to achieve permanent
changes in an individual’s substance using behavior.
Designed to provide a minimum of 6 hours of structured
counseling and educational services per week.
Provides comprehensive assessments, individualized
treatment plans, and has active affiliations with other levels
of care to address an individual’s needs.
Designed to provide a minimum of 6 hours of structured
counseling and educational services per week along with
medication assisted treatment.
Provides comprehensive assessments, individualized
treatment plans, and has active affiliations with other levels
of care to address an individual’s needs
12 Updated April 2015
Outpatient therapy is the least restrictive
community based treatment
Evidence Based Practices:
Prolonged Exposure (PE)
For individuals who need more support than
outpatient therapy can provide.
Psychiatric needs are met by referring to additional
services as needed.
Evidence Based Practices:
Prolonged Exposure (PE)
Psychiatric needs are met by referring to additional
services as needed.
Evidence Based Practices:
Prolonged Exposure (PE)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Halfway House*
Detoxification*
Short Term
Residential*
Elements of Treatment
Community-based residential treatment and rehabilitation
facility that provides services for chemically dependent
persons in a supportive, chemical-free environment. It is
meant to provide a “home-like atmosphere in the local
community. While substance abuse treatment is provided,
the emphasis is on providing protective and supportive
elements of family living, and encouraging and providing
opportunities for independent growth and responsible
community living. Mutual self-help, assistance in
economic/social adjustment, and integration of life skills
into daily life are built into the program, along with assisting
residents in the development of a solid program of
recovery.
For clients who are currently exhibiting withdrawal
symptoms or withdrawal is imminent. Detoxification is
indicated when there is evidence that the client has been
using a physically dependent drug (opiates,
benzodiazepines, alcohol) on a daily basis for an extended
period of time, and the client demonstrates that he has
developed tolerance.
24-hour, professionally directed evaluation, care and
treatment for addicted clients in acute distress, whose
addiction symptomatology is demonstrated by moderate
impairment of social, occupational or school functioning.
13 Updated April 2015
Clinical Considerations
Specialty teams and
Evidence Based
Practices** (available at
some providers)
Specialty Facilities:
Homeless Halfway House
There is no established detoxification protocol for
Cannabis and/or Cocaine, as use of these drugs
does not result in physical dependency.
Specialty: Medically Managed
The goal of short term residential treatment is
rehabilitation.
Specialty: Medically Managed
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Long Term
Residential*
Elements of Treatment
24-hour professionally directed evaluation and
rehabilitation services to substance abusing/dependent
clients. The defining characteristic of this level of care is
that they service clients who assistance with basic living
skills (ie parental skills) in order to develop sufficient
recovery skills.
14 Updated April 2015
Clinical Considerations
The goal of long-term residential treatment is
habilitation.
Specialty teams and
Evidence Based
Practices** (available at
some providers)
Specialty: Mother-baby
programs; Journey of Hope
(homeless)
Evidence Based Practices:
Prolonged Exposure (PE),
Cognitive Behavioral Therapy
(CBT)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Clinical Considerations
Specialty teams and
Evidence Based
Practices** (available at
some providers)
Residential Services
This is a transitional level of care for aging out youth and/or
adults in need of a step-down from a more structured
setting, who are working toward family reunification,
permanency goals, re-entry into the community and/or
independent living. The focus is on the development of
social, occupational, educational and vocational supports
needed to successfully reintegrate into the community.
Residential
Treatment
Facility- Adult
(RTF-A)*
Treatment at RTFAs typically includes:





Individual and Group Therapy 1 to 4 times per
week
Family Therapy
Specialized Therapy/Skills Building Sessions 1 to
2 times per week
Psychiatric Services
A brief, intense, focused treatment program to
promote a successful return by the
child/adolescent to the community
15 Updated April 2015
Appropriate for aging out youth who require
ongoing support focused on the development of
positive coping skills, anger management skills, life
skills, social skills and enhanced problem solving
abilities.
Specialty Services:
Deaf and Hard of Hearing,
Complex Medical Issues, CoOccurring MH and
D and A, Co-Occurring MH
and ID
Evidence Based Practices:
Dialectical Behavioral
Therapy (DBT)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Clinical Considerations
Specialty teams and
Evidence Based
Practices** (available at
some providers)
Acute Services
A treatment program that combines elements of the
inpatient and outpatient setting in a structured
therapeutically intensive treatment program that
coordinates clinical services to achieve a stable therapeutic
milieu.
Acute Partial
Hospital Program
(APHP)*
Subacute Partial
Hospital Program
Subacute
Psychiatric
Inpatient
Program(SAIP)*
Signs and symptoms of behavioral disorders are carefully
and continuously monitored to document progress or
regression. Prompt and effective intervention is a hallmark
of a PHP and often averts hospitalization.
APHP offers an alternative to hospitalization for
members that do not represent an imminent
danger to themselves or others.
Often utilized as a step down from inpatient units or
as a step up from outpatient to prevent further
decomposition and/or allow for close monitoring
when making medication changes.
Admissions and continued stay is based on a
psychiatric evaluation and determination of medical
necessity.
A treatment program that provides less than 24 hour care
for members who are stabilized post-crisis, but require
more ongoing support than is available in traditional
outpatient or aftercare programs. Members’ signs and
symptoms are generally less severe than those requiring
an Acute Partial Hospital Program.
Members often step down from an Acute Partial
Hospital Program as a natural step in the
progression of treatment. Subacute Partial Hospital
Programs help members continue the progress
they have made in more intensive treatment
settings. The goal is to assist with improving
members’ level of functioning in the community.
Provides short term care to individuals with a mental health
diagnosis within a hospital or non-hospital facility.
Member must have a clear discharge plan on
admission, must have the capacity to remain safe
on an unlocked unit.
16 Updated April 2015
Member is awaiting non-hospital placement and
there is a demonstrated need for a structured,
Specialty Services:
Eating Disorders
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Elements of Treatment
Clinical Considerations
supportive environment and without such there is a
high likelihood for the resumption of acute
symptomatology.
A non-hospital, unlocked facility where the goal of
treatment is to re-stabilize after a mild to moderate
decompensation period or as a step down from the acute
inpatient setting.
Crisis Residence
(CR)*
Acute inpatient treatment is designed to meet the needs of
adults whose behaviors and thought processes pose a
substantial risk to themselves and/or others.
Acute Inpatient
Hospital Program
(AIP)*
The purpose of AIP is to evaluate, diagnose and stabilize
acute symptoms.
Admissions and continued stay is based on a
psychiatric evaluation and determination of medical
necessity.
Member must have a clear discharge plan on
admission
CR is not required to have a physician on site daily,
and psychiatric consults are conducted on an asneeded basis.
Crisis Residence is appropriate for: members who
are awaiting placement in structured housing or
residential treatment and are at demonstrated risk
of decompensation without ongoing structure in the
interim.
The primary consideration for acute care is the
type and acuity of symptoms in the clinical
presentation. Members in this setting may lack
adequate impulse control, the ability to cooperate
with staff, the ability to communicate effectively
with staff and to accomplish the activities of daily
living without significant support.
Admissions and continued stay is based on a
psychiatric evaluation and determination of medical
necessity.
17 Updated April 2015
Specialty teams and
Evidence Based
Practices** (available at
some providers)
CBH Continuum of Adult Services
All Services are for age 18 and up. Services marked (*) require preauthorization
Service
Extended Acute
Care (EAC)*
Elements of Treatment
Long-term psychiatric inpatient level of care for adults
diagnosed with chronic and persistent mental illness who,
due to the nature of their illness, typically require an
extended episode of treatment to return to baseline
functioning.
Clinical Considerations
EAC is considered for members with a history of
multiple hospitalizations in close succession that
suggests that the client could benefit from an
extended episode of acute treatment in order to
successfully reside in a supportive community
setting or for members whose current
symptomatology is severe and the member has not
responded to trials of psychotropic medication
Specialty teams and
Evidence Based
Practices** (available at
some providers)
Evidence Based Practice:
Cognitive Behavioral Therapy
(CBT)
** Providers who offer these Evidence Based Practices have been trained by DBHIDS and/or have an active relationship with treatment developers.
18 Updated April 2015