Individuals who are Medicaid eligible and who meet medical necessity criteria are eligible for PHP services. The assessment described below will determine if you are eligible and if so, what intensity of service you are eligible to receive. The Medicaid to non-Medicaid ratio of clients served is based on resource availability. An individual may meet non-Medicaid criteria for services but actual service provision is dependent upon the availability of PHP financial resources. Fewer spaces are available for non-Medicaid persons.
Medical necessity is established for each client on an individual basis.
Assignment to a tier is based on the medical necessity criteria, service history and consumer preferences. Clients and family members are encouraged to actively participate in treatment planning and designation of outcomes and goals. Each client receives an individual treatment plan as part of the assessment process. Services for each client vary according to need and consumer choice. Some agencies chose to specialize in certain service areas.