Section 131.APPENDIX A  DHS/DMH Target Population

The DHS/DMH target population, for purposes of this Part, consists of children 17 years of age or younger who meet the diagnoses criteria of subsection (a) and treatment history of subsection (b) or who meet the diagnoses criteria of subsection (a) and functional criteria of subsection (c).

a)         Diagnoses

One of the following DSM-IV diagnoses that is the focus of the treatment being provided:

1)         Attention Deficit/Hyperactivity Disorders (314.00, 314.01, 314.9)

2)         Schizophrenia (295.xx)

3)         Schizophreniform Disorder (295.4)

4)         Schizo-Affective Disorder (295.7)

5)         Delusional Disorder (297.1)

6)         Shared Psychotic Disorder (297.3)

7)         Brief Psychotic Disorder (298.8)

8)         Psychotic Disorder (298.5)

9)         Bipolar Disorders (296.0x, 296.4x, 296.5x, 296.6x, 296.7, 296.80, 296.89, 296.90)

10)         Cyclothymic Disorder (301.11)

11)         Major Depression (296.2x, 296.3x)

12)         Panic Disorder with or without Agoraphobia (300.01, 300.21)

13)         Obsessive-Compulsive Disorder (300.30)

14)         Anorexia Nervosa (307.1)

15)         Bulimia Nervosa (307.51)

16)         Post Traumatic Stress Disorder (309.81)

17)         Intermittent Explosive Disorder (312.34)

18)         Tourette’s Disorder (307.23)

b)         Treatment History

Treatment history covers the client’s lifetime treatment and is restricted to treatment for a DSM-IV diagnosis specified in subsection (a).

The youth must meet at least ONE of the following criteria:

1)         Continuous treatment of six months or more in one, or a combination of, the following:

A)        inpatient treatment;

B)        day treatment; or

C)        partial hospitalizations.

2)         Six months of continuous residence in a residential treatment center.

3)         Two or more admissions of any duration to inpatient treatment, day treatment, partial hospitalization or residential treatment programming within a 12 month period.

4)         A history of using the following outpatient services over a one year period, either continuously or intermittently:

A)        psychotropic medication management;

B)        case management; or

C)        SASS/intensive community-based services.

5)         Previous treatment in an outpatient modality and a history of at least one mental health psychiatric hospitalization.

c)                  Functional Criteria

Functional criteria has been purposely narrowed to descriptors of the most serious levels of functional impairment and are not intended to reflect the full range of possible impairments.

The functional impairment must be the result of the mental health problems for which the child is, or will be, receiving care and must be expected to persist in the absence of treatment.

The youth must meet criteria for functional impairment in TWO of the following areas:

1)         Functioning in self care – Impairment in age-appropriate self-care skills is manifested by a person’s consistent inability to take care of personal grooming, hygiene, clothing, and meeting of nutritional needs.

2)         Functioning in community – Impairment in community functioning is manifested by a consistent lack of age-appropriate behavioral controls, decision-making, judgment and value systems that results in potential involvement in the juvenile justice system.

3)         Functioning in social relationships – Impairment of social relationships is manifested by the consistent inability to develop and maintain satisfactory relationships with peers and adults.

4)         Functioning in the family –

A)        Impairment in family functioning is manifested by a pattern of:

i)          disregard for the safety and welfare of self or others, e.g., fire setting, serious and chronic disruptiveness;

ii)         significantly disruptive behavior exemplified by repeated and/or unprovoked violence to siblings and/or parents; or

iii)        inability to conform to reasonable limitations and expectations.

B)         The degree of impairment requires intensive (i.e., beyond age-appropriate) supervision by parent/caregiver and may result in removal from the family or its equivalent.

5)         Functioning at school – Impairment in functioning at school is manifested by the inability to pursue educational goals in a normal time frame, e.g., consistently failing grades, repeated truancy, expulsion, property damage, or violence toward others that cannot be remediated in a classroom setting (whether traditional or specialized).