Eligibility for SMCN programs is based on the Public Mental Health System.
The goals of the Public Mental Health System (PMHS) are to:
The public mental health system serves three main groups of people:
Special Populations
Eligible Uninsured:
People without Medicaid may be served in the PMHS if the following conditions are met:
Veterans:
Medical care, including psychiatric care, is one of the benefits veterans may be entitled to receive. In order to determine eligibility and to get these benefits, it is necessary to apply to the Department of Veterans Affairs. The Disable American Veterans organization may help veterans to complete the application process. Call 202-554-3506 for more information.
There is a Maryland Department of Veterans Affairs to assist Maryland Veterans to get help; call 410-333-4428. In addition, there are VA Regional Offices where a person can get benefit information and where to go; call 1-800-827-1000.
Homeless:
The Mental Hygiene Administration receives federal money to provide mental health services to homeless people in shelters and on the streets. MHA transfers the money to the Core Service Agencies who then contract with providers to provide outreach, case management, eviction prevention, security deposits, crisis intervention, housing subsidies, emergency purchases (food, medication, etc.) and assist people in getting treatment. For information on local homeless programs contact the Core Service Agency in the County you reside in.
Priority Population – Adults (Rehab and Residential Programs)
SEVERELY MENTALLY ILL
PRIORITY POPULATION DEFINITION - ADULTS (SMI)
Revised 9/1/03, 3/10/14
Reviewed 05/10/07, 1/25/10
INCLUDED DIAGNOSES (DSM-5 – including ICD-9 and ICD-10 diagnosis codes):
295.90/F20.9 Schizophrenia
295.40/F20.81 Schizophreniform Disorder
295.70/F25.0 Schizoaffective Disorder, Bipolar Type
295.70/F25.1 Schizoaffective Disorder, Depressive Type
298.8/F28 Other Specified Schizophrenia Spectrum and Other Psychotic Disorder
298.9/F29 Unspecified Schizophrenia Spectrum and Other Psychotic Disorder
297.1/F22 Delusional Disorder
296.33/F33.2 Major Depressive Disorder, Recurrent Episode, Severe
296.34/F33.3 Major Depressive Disorder, Recurrent Episode, With Psychotic Features
296.43/F31.13 Bipolar I Disorder, Current or Most Recent Episode Manic, Severe
296.44/F31.2 Bipolar I Disorder, Current or Most Recent Episode Manic, With Psychotic Features
296.53/F31.4 Bipolar I Disorder, Current or Most Recent Episode Depressed, Severe
296.54/F31.5 Bipolar I Disorder, Most Recent Episode Depressed, With Psychotic Features
296.40/F31.0 Bipolar I Disorder, Current or Most Recent Episode Hypomanic
296.40/F31.9 Bipolar I Disorder, Current or Most Recent Episode Hypomanic, Unspecified
296.7/F31.9 Bipolar I Disorder, Unspecified
296.89/F31.81 Bipolar II Disorder
301.22/F21 Schizotypal Personality Disorder
301.83/F60.3 Borderline Personality Disorder
INCLUDED DIAGNOSES (DSM-IV):
295.10 Schizophrenia, Disorganized Type
295.20 Schizophrenia, Catatonic Type
295.30 Schizophrenia, Paranoid Type
295.40 Schizophreniform Disorder
295.60 Schizophrenia, Residual Type
295.70 Schizoaffective Disorder
295.90 Schizophrenia, Undifferentiated Type (*includes ICD-9 diagnoses 295.10-295.95)
296.33 Major Depressive Disorder, Recurrent, Severe Without Psychotic Features
296.34 Major Depressive Disorder, Recurrent, Severe With Psychotic Features
297.1 Delusional Disorder
298.9 Psychotic Disorder, NOS
301.22 Schizotypal Personality Disorder
301.83 Borderline Personality Disorder
296.43 Bipolar I Disorder, Most Recent Episode, Manic, Severe Without Psychotic Features
296.44 Bipolar I Disorder, Most Recent Episode, Manic, Severe With Psychotic Features
296.53 Bipolar I Disorder, Most Recent Episode, Depressed, Severe Without Psychotic Features
296.54 Bipolar I Disorder, Most Recent Episode, Depressed, Severe With Psychotic Features
296.63 Bipolar I Disorder, Most Recent Episode, Mixed, Severe Without Psychotic Features
296.64 Bipolar I Disorder, Most Recent Episode, Mixed, Severe With Psychotic Features
296.80 Bipolar Disorder, NOS
296.89 Bipolar II Disorder
-and-
In order to be included in the PRIORITY POPULATION, individuals must meet the target diagnostic criteria and meet the following functional limitations:
Serious mental illness is characterized by impaired role functioning, on a continuing or intermittent basis, for at least two years, including at least three of the following:
Inability to maintain independent employment,
Social behavior that results in interventions by the mental health system,
Inability, due to cognitive disorganization, to procure financial assistance to support living in the community,
Severe inability to establish or maintain a personal support system, or
Need for assistance with basic living skills.
The diagnostic criteria may be waived for the following two conditions:
1. An individual committed as not criminally responsible who is conditionally released from a Mental Hygiene Administration facility, according to the provisions of Health General Article, Title 12, Annotated Code of Maryland. Or
2. An individual in a Mental Hygiene Administration facility with a length of stay of more than 6 months who requires RRP services, but who does not have a target diagnosis. This excludes individuals eligible for Developmental Disabilities services.