Used to see if you have a substance use concern. It helps providers know the best way to help you.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

Tests to see if your hair, urine, or saliva shows that there is alcohol or drugs in your body.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

If you have Serious and Persistent Mental Illness (SPMI)*, you may be able to participate in ACT. An ACT Team helps you live independently and continue your recovery in the community. Services include individualized treatment planning, crisis intervention, peer services, community-based rehabilitation services, medication management, case management, individual and group therapy, co-occurring treatment, and coordination of other community support services.

*In order to be considered as having an SPMI, a member must 1) meet the criteria for Serious Mental Illness, 2) have at least one (1) additional functional impairment, and 3) have a diagnosis under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) of one (1) of the following: Schizophrenia, Schizoaffective Disorder, Bipolar I Disorder, Bipolar II Disorder, Major Depressive Disorder Recurrent Severe, Delusional Disorder, or Borderline Personality Disorder.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

If you live in Enhanced Safe and Sober Housing, you can get basic housing essentials like bedding, towels, soap, toothpaste, etc.

• Medicaid: Not Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

Case management is a collaborative process with a behavioral health professional. A case manager helps facilitate and advocate for options and services to meet your needs. If you have mental health concerns, a trained mental health expert can help you access and coordinate care for your physical and mental health. They can also help you with community-living needs.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

Case management is a collaborative process with a behavioral health professional. A case manager helps facilitate and advocate for options and services to meet your needs.

If you have substance use concerns, a trained expert can help you access and coordinate your care for your physical and mental health. They can also help you with community-living needs.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

If you have substance use concerns and need to go to an appointment or a treatment facility, you could get free or low-cost childcare while you are there.

• Medicaid: Not Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

The CDA helps providers understand your mental health and substance use concerns and develop a care plan. It includes a review of your health history and any family-related issues. A CDA needs to be completed every twelve (12) months. It can be updated more often if needed.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

Crisis* Centers offer you in-person help if you are having a mental health or substance use crisis. You may stay at a Center for up to 23 hours and 59 minutes. This is available for all Idahoans.

*A crisis is when you or someone you know is having sudden and severe mental health concerns, and you are unsure of what to do. See the How to Get Care page for more information.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

With crisis* intervention services, you can talk to a behavioral health expert 24 hours a day, 7 days a week. The person will work with you to manage the crisis and make a plan to improve your situation.

*A crisis is when you or someone you know is having sudden and severe mental health concerns, and you are unsure of what to do. See the How to Get Care page for more information.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

Crisis* psychotherapy is for when you have a behavioral health crisis but are not at risk of hurting yourself or others. You talk with a trained therapist to explore and address the issues that led to your crisis. The goal is to help you get stable quickly.

*A crisis is when you or someone you know is having sudden and severe mental health concerns, and you are unsure of what to do. See the How to Get Care page for more information.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

You can call 988 24 hours a day, 7 days a week, if you are having a behavioral health crisis.* This service gives you immediate help over the phone, text or chat with trained professionals. Staff will listen and connect callers to the right levels of care. The crisis call center is available for all Idahoans.

*A crisis is when you or someone you know is having sudden and severe mental health concerns, and you are unsure of what to do. See the How to Get Care page for more information.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

If you start to have signs of serious mental illness that interferes with your life, you may have ESMI.* The STAR program is for people who:

• Are between 15 and 30 years old
• Have experienced ESMI within the past two (2) years
• Have not received treatment
• Meet the criteria in the most recent version of The Diagnostic and Statistical Manual of Mental Disorders

Services include:

• Assessments
• Treatment plans
• Psychoeducation
• Crisis intervention
• Case management and coordination
• Psychotherapy (individual and group)
• Peer support
• Medication management
• Education and career help

*ESMI is a condition that affects an individual, regardless of their age, and that is a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within the current version of The Diagnostic and Statistical Manual of Mental Disorders as published by the American Psychiatric Association (APA). For a significant portion of the time since the onset of the disturbance, the individual has not achieved or is at risk for not achieving the expected level of interpersonal, academic, or occupational functioning. This definition is not intended to include conditions that are attributable to the psychologic effects of a substance, substance use disorder, are attributable to an intellectual developmental disorder or another medical condition. The term ESMI is intended for the initial period of onset of the symptoms.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

ECT is a medical treatment most used for severe major depression disorder or bipolar disorder that has not responded to other treatments. ECT involves a brief electrical stimulation of the brain while you are under anesthesia in a hospital.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

If you are in recovery from substance use concerns and are leaving a psychiatric hospital or other facility, you might be able to get ESSH. ESSH provides a safe, clean and sober place where you can continue your recovery. Houses have a substance use disorder-qualified house manager who lives there 24 hours a day, 7 days a week. You get recovery coaching, medication monitoring, and extra support for SUD- and mental health-related issues.

ESSH is different than regular Safe and Sober Housing (SSH) in these ways:

• In ESSH, the house manager lives in the house all the time. In SSH, they do not.
• ESSH is for people who are leaving inpatient or residential treatment. SSH is for people in recovery and active treatment or waiting for active treatment.

• Medicaid: Not Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

If you have Serious Mental Illness (SMI)* or Serious and Persistent Mental Illness (SPMI)** you and your family can get information that can help you understand your needs and strengths. This service is to help you learn about and understand your condition, so you can manage and make decisions in an informed way. Depending on what you need help with, you can come to sessions with just your family or a group of families that share the same experiences.

*In order to be considered as having an SMI, a member must 1) have a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet the diagnostic criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and 2) have a functional impairment that substantially interferes with or limits one (1) or more major life activities.

**In order to be considered as having an SPMI, a member must 1) meet the criteria for SMI, 2) have at least one (1) additional functional impairment, and 3) have a diagnosis under DSM-5 with one (1) of the following: Schizophrenia, Schizoaffective Disorder, Bipolar I Disorder, Bipolar II Disorder, Major Depressive Disorder Recurrent Severe, Delusional Disorder, or Borderline Personality Disorder.

• Medicaid: Covered
• Other State Funds: Not Covered
• Pre-Authorization Required: Yes

If you have mental health concerns, you and your family can talk with a behavioral health expert who will help you and your family learn coping and other skills.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

Functional assessments measure your ability to do things needed for daily living. It measures your strengths and needs.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

After a you have successfully completed treatment for a substance use concern, you can meet with a group of people on a regular basis. These people are going through the same kinds of things you are going through. The group members support each other in recovery.

• Medicaid: Not Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

If you have a mental health or substance use concern, you can meet with a group of three or more people with similar concerns. You and the other group members will talk and support each other. You may practice coping skills to learn how to manage issues. The group is led by a behavioral health expert who helps you be safe.

• Medicaid: Not Covered
• Other State Funds: Not Covered
• Pre-Authorization Required: No

If you have Serious and Persistent Mental Illness (SPMI)* or more than one mental health concern, you may be able to live in a HART home. HART is a program where people with the same conditions live together in the community. In a HART home, you will get medically necessary services that may include:

• Comprehensive diagnostic assessment
• Peer support
• Case management
• Crisis response and intervention
• Individualized skills building treatment plan
• Psychotherapy (individual and group)
• Medication management
• Skills building/CBRS
• Skills training and development
• Treatment planning

*In order to be considered as having an SPMI, a member must 1) meet the criteria for Serious Mental Illness, 2) have at least one (1) additional functional impairment, and 3) have a diagnosis under DSM-5 with one (1) of the following: Schizophrenia, Schizoaffective Disorder, Bipolar I Disorder, Bipolar II Disorder, Major Depressive Disorder Recurrent Severe, Delusional Disorder, or Borderline Personality Disorder.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

If you have a mental health or substance use concern, you can talk with a trained therapist to explore and address emotional, mental, and behavioral challenges. It provides a safe space to discuss concerns, understand feelings, and develop coping strategies to improve overall wellbeing.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

A trained clinician and a skills helper work with you and your family to create a personalized treatment plan. The approach focuses on your strengths and helps you meet goals.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

If you have a mental health concern (with or without a co-occurring substance use concern), and your thoughts, mood, perception, or behavior is substantially impaired, you may need to be admitted to the hospital as inpatient. Inpatient care is when you get covered services in a hospital and stay there overnight for at least one day.

If you do not have Medicaid, other state funds will cover inpatient care only if you are involuntarily admitted.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

If you have a substance use concern and need medically managed withdrawal treatment and related care, you may need to be admitted to the hospital as inpatient. Inpatient care is when you get covered services in a hospital and stay there overnight for at least one day.

• Medicaid: Covered
• Other State Funds: Not Covered
• Pre-Authorization Required: Yes

This is a structured program for you if you have mental health or substance use symptoms that can be managed in a level of care that is less intensive than partial hospitalization but higher than basic outpatient care. Services include:

• Assessment and treatment planning
• Psychotherapy and/or psychoeducation
• Skill-building activities
• 24-hour crisis services
• Psychiatric evaluation
• Medication management
• Substance use screening and monitoring, and drug testing (as appropriate)
• Physical exam
• Care coordination/transition management/discharge planning
• For eating disorders:
• Health assessment and monitoring
• Dietary and nutrition services

You may also get these services outside the program:

• Separate case management
• Respite
• Peer support
• Recovery coaching
• Psychological/neuropsychological testing                

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

If you are in recovery from substance use concern, life skills can help you cope with the demands and challenges of life. Programs can help you enhance personal or family relationships, reduce work or family conflict, and adopt healthy, recovery-oriented behaviors.

• Medicaid: Not Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

A doctor or nurse meets with you to discuss the medicines you take and order new ones you might need.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

Medication-assisted treatment (MAT) is the use of medications, sometimes in combination with counseling and behavioral therapies, to treat substance use disorders. MAT helps treat opioid use disorder and alcohol use disorder and can help you to sustain recovery.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

Mobile response is a brief community-based intervention to help you if you are in a mental health crisis.* Teams identify your stressors and focus on your strengths and natural supports to de-escalate the crisis and prevent future crises. Mobile Response will be delivered in the community. This is available for all Idahoans.

*A crisis is when you or someone you know is having sudden and severe mental health concerns, and you are unsure of what to do. See Getting Care chapter for more information.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

If you have a mental health concern, you and your family can meet with other families who face similar challenges. In a group setting with a trained professional, you and others discuss and work on emotional concerns. The goal is to help you and your family grow, handle your emotions better, and improve your daily life skills.

• Medicaid: Covered
• Other State Funds: Not Covered
• Pre-Authorization Required: No

Formal sets of tests that help detect brain damage, injuries or other issues. They can reveal challenges in how the brain functions. These tests are given by a psychologist.

• Medicaid: Not Covered
• Other State Funds: Not Covered
• Pre-Authorization Required: No

If you have a substance use concern, you can meet with a therapist for help. You will learn how to:

• Stop using substances and stay substance free
• Change behaviors
• Repair relationships
• Make new friends who don’t use substances
• Create a recovery lifestyle

You can meet with a therapist by yourself or in a group.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

This is a structured program for you if you have mental health or substance use symptoms that can be managed in a level of care that is less intensive hospitalization but higher than intensive outpatient care. You attend this structured program for 20 or more hours a week. You do not spend the night in the hospital. Services include:

• Assessment and treatment planning
• Psychotherapy and/or psychoeducation
• Skill-building activities
• 24-hour crisis services
• Psychiatric evaluation
• Medication management
• Substance use screening and monitoring, and drug testing (as appropriate)
• Physical exam
• Care coordination/transition management/discharge planning
• For eating disorders:
  • Health assessment and monitoring
  • Dietary and nutrition services

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

If you are recovering from a mental health concern, you can get support from a Certified Peer Support Specialist (CPSS). A CPSS is a person in recovery from mental health concerns who uses lived experience and special training to help others in recovery. For more information, see the Care Management section of this website.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

Formal sets of written, visual or verbal tests that are given by a psychologist. They help providers understand how you think, feel and behave. They can also help determine your strengths, challenges, personality and how you handle situations.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

If you are recovering from a substance use concern, you can get support from a Certified Recovery Coach (CRC) or a Certified Peer Recovery Coach (CPRC).* These coaches are your advocate, guide, leader, and mentor. They help you get connected to services and connect you to the recovery community. They help you create a recovery and resiliency plan that meets your needs. If you have a relapse they, can help you re-engage in supports and treatments. If you work with a CRC/CPRC, you may have fewer and less severe relapses.

*The difference between a CRC and a CPRC is that a CRC is not required to be in recovery themselves. CPRCs are all in recovery themselves.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

If you have a mental health and/or substance use concern and your psychiatric, behavioral, or cognitive problems are severe that you need 24-hour care, you could go to a residential treatment center. A residential treatment center is not a hospital. Services include:

• Psychiatric care
• Psychological care
• Therapeutic and behavior modification
• Psychotherapy
• Nursing care
• Family visits
• Psychoeducation

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

If you are in recovery from a substance use concern and in active treatment or waiting for active treatment, you may be able to live in an SSH. SSH provides a safe, clean and sober place for you to continue your recovery. A house manager who may or may not live in the house is available to support you 24 hours a day, 7 days a week. You would need to pay a fee for amenities and utilities.

SSH is different than Enhanced SSH in these ways:

• In SSH, the house manager does not live in the house all the time. In ESSH, they do.
• SSH is for people in recovery and active treatment or waiting for active treatment. ESSH is for people who are leaving inpatient or residential treatment.

• Medicaid: Not Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

If you have a mental health concern that makes it hard for you to do everyday tasks, this service can help. You will work in a group to learn important daily living skills.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

If you have a mental health concern, you might be able to get CBRS at home or in the community. Providers use special techniques to help you improve behavior, social skills, communication, and daily living skills. It can help boost your abilities and confidence. It can help reduce mental health symptoms.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

A doctor or nurse may give you medicine you need in a shot form. Injections may help people with long-term conditions. They can lead to better results and consistent use. Sometimes injections are the best way to get certain medicines.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: No

TMS uses a magnetic field to influence brain activity. It can help if you have depression, obsessive-compulsive disorder, or another condition that has not improved with treatment. It is not invasive. The side effects are usually mild and temporary. TMS takes place in an office, not a hospital, and does not involve anesthesia.

• Medicaid: Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes

If you have substance use concerns and do not have a way to get to treatment appointments, you can get free or low-cost travel. If you are in overnight care, you can also get free or low-cost travel for your child to visit you. To get transportation:

• If you do not have Medicaid, call Magellan at 1-855-202-0973 (TTY 711) 24 hours a day, 7 days a week
• If you have Medicaid, visit www.mtm-inc.net/idaho/ or call MTM at 1-877-503-1261 (TTY 711).

• Medicaid: Not Covered
• Other State Funds: Covered
• Pre-Authorization Required: Yes