Indiana Medicaid offers coverage for the Child Mental Health Wraparound (CMHW) home and community-based services (HCBS). These services are provided to youth, ages 6-17, who have a diagnosis of a serious emotional disturbance.

Age 6 through 17

• Youth found to be eligible for CMHW services in their 17th year will be entitled to receive 12 months of services so long as all other eligibility requirements continue to be met. For example, a youth enrolled at 17 and a half years of age may continue his or her approved level-of-need year through age 18 and a half as long as the youth continues to meet all other eligibility criteria.
• If the youth participate in Wraparound services through CMHI, the services will terminate at age 18 regardless of when they were approved.

Resides in his or her home or community

Meets criteria for two or more DSM-V (or subsequent revision) diagnoses not excluded as exclusionary criteria (see the Exclusionary Criteria section noted below)

In addition to meeting the CMS-approved target group criteria, the applicant must also meet CMHW needs-based criteria, which includes:

• Applicant demonstrates dysfunctional patterns of behavior, due to one or more of the following behavioral or emotional needs, as identified on the Child and Adolescent Needs and Strengths (CANS) assessment tool: Adjustment to trauma; Psychosis; Debilitating anxiety; Conduct problems; Sexual aggression or Fire-setting
• Family/caregiver demonstrates significant needs in at least one of the following areas, as indicated on the CANS assessment: Mental health; Supervision; Family stress; Substance abuse

Youth does not meet the following Exclusionary Criteria for CMHW, which are used to identify youth the CMHW program is not designed to serve. A youth with any of the following criteria is not eligible for CMHW:

• Primary substance use disorder
• Pervasive developmental disorder (autism spectrum disorder)
• Primary attention deficit hyperactivity disorder
• Participant with an intellectual/developmental disability (I/DD)*
• Dual diagnosis of serious emotional disturbances and intellectual disability
• Youth that resides in an institutional or otherwise HCBS non compliant setting

Covered Services:

In addition to Indiana Medicaid covered-services, individuals receiving CMHW services are eligible for the following:

• Wraparound facilitation
• Habilitation
• Respite care
• Family support and training for the unpaid caregiver

Member Information

• To apply, you must first submit a referral to the access site.
• You must also apply for Medicaid.  You can learn more about applying for Medicaid by going to the Apply for Coverage webpage.
• For more information on CMHW, please visit FSSA’s CMHW webpage or email DMHAYouthServices@fssa.in.gov.