What services does Medicaid cover to serve people with behavioral health needs?

If you have Medicaid health care coverage, specialized services are available. Please note that you first need to meet with your Primary Care Physician (PCP) to get prescriptions or referrals before you can get these services:

• Supported Employment
• Adult Rehabilitative Day Service
• Adult Life Skills Development
• Partial Hospitalization
• Therapeutic Communities
• Supportive Housing
• Peer Support Aftercare Recovery Support (for Substance Abuse)

What is an Independent Assessment, and how do I know if I need one?

If you need certain services, you will be served by a PASSE. To help the PASSE best serve your needs, you need to get an Independent Assessment to measure what you do best and what skills you need help doing. A company named Optum performs these assessments for DHS, and Optum will contact you to set up a time that is best for you. If you’re wondering when your next one needs to happen, you can find out from Shelby Maldonado at [email protected].

What is a PASSE?

PASSE is a program that serves Medicaid clients with complex behavioral health, developmental, or intellectual disabilities. There are three PASSEs that monitor their clients’ health care needs, keep them healthy, and help them reach goals.

A Medicaid client’s services are managed and reimbursed by the PASSEs if the person:

• is on the Developmental Disabilities (DD) Waiver
• is on the DD Waiver wait list and gets Medicaid state plan services
• lives in a private DD Intermediate Care Facility
• has a Behavioral Health (BH) diagnosis and needs services in addition to counseling and medication management

Once a year during Open Enrollment in October, clients may choose to switch PASSEs.

I have a PASSE, but my PASSE is denying a service I need. Can I contact someone at DHS to help?

We recommend you first call your PASSE to speak with them, but you may also contact the PASSE Ombudsman Office:

• Call: 1-844-843-7351
  • Individuals who have a hearing or speech impairment can contact our office by calling toll free, 1-888-987-1200,
• Email: [email protected]