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ACT | Ohio Medicaid Eligibility Criteria

This free PDF resource is designed to help service providers determine whether a Medicaid recipient (person who receives Medicaid) in the State of Ohio is eligible to receive ACT services that are billable to Medicaid. This version of the "Ohio Medicaid ACT Eligibility Criteria" is based upon "OAC 5160-27-04: Mental Health Assertive Community Treatment Service" (ver. 8/29/2017). The document includes notes in text boxes with examples or possible sources of information and documentation that may help determine whether a person meets a specific criterion or not.

Examples of criteria addressed in this tool include the following:

  • Diagnosis(es)
  • Benefits such as SSI & SSDI
  • Adult Needs and Strengths Assessment (ANSA)
  • Institutional utilization and other functional criteria
  • Persistent or recurrent severe psychiatric symptoms
  • Coexisting substance use disorder
  • Housing: residing in an inpatient or supervised residence
  • At risk of psychiatric hospitalization, institutional, or supervised residential placement
  • Has been unsuccessful in using traditional office-based outpatient services

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ACKNOWLEDGEMENTS

This resource was produced by our Center's Ohio Assertive Community Treatment Coordinating Center of Excellence (ACT CCOE) initiative with support from the Ohio Department of Medicaid (ODM).

MORE INFORMATION

To learn more about Assertive Community Treatment (ACT), the evidence-based practice, and our consulting and training services for ACT implementation, visit the "practices" section of our website (click here).

CITATION

Title: ACT | Ohio Medicaid Eligibility Criteria
Author(s): Center for Evidence-Based Practices
Publication Year: 2018
Publisher City: Cleveland, Ohio
Publisher Name: Ohio Department of Medicaid (ODM)

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  • ACT | Ohio Medicaid Eligibility Criteria

    $0 / Free PDF Download / The Ohio Medicaid ACT Eligibility Criteria is designed to help service providers determine whether a Medicaid recipient in the State of Ohio is eligible to receive ACT services that are billable to Medicaid. The document includes notes with examples or possible sources of information and documentation that may help determine whether a person meets a specific criterion or not.

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