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Kentucky Determination Criteria Checklist for Serious Mental Illness (SMI) Relates to KRS 210.005 and 907 KAR 15:060, 15:065, 15:050, and 15:055, and 908 KAR 2:260 Individuals Name Identification.

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This guide provides comprehensive instructions for users on how to fill out the 908 Kar 2 260 form online. It is designed to assist individuals at all levels of experience with legal documentation.

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  1. Click ‘Get Form’ button to obtain the document and access it in your preferred editor.
  2. Begin by entering the individual's name, identification number, and diagnostic code(s) in the designated fields at the top of the form.
  3. Review the criteria outlined in the table, ensuring to check the appropriate boxes under the 'YES' or 'NO' columns. This includes verifying the person's age, mental health diagnosis, and whether they exhibit functional impairments.
  4. In the 'Diagnosis' section, circle any relevant mental health diagnoses as specified in the Diagnostic and Statistical Manual of Mental Disorders. Ensure that the chosen diagnosis aligns with the individual's current condition.
  5. In the 'Disability' section, indicate the domains in which the individual displays clear evidence of functional impairment by circling the applicable areas. Discuss these with relevant professionals if necessary.
  6. In the 'Duration' section, circle at least one of the specified duration conditions that apply to the individual, confirming that they meet the required criteria over the designated time periods.
  7. Complete the final part of the form by having it signed by a qualified, licensed behavioral health professional who conducted the assessment. This section requires their printed name, credentials, signature, and the date.
  8. Once all fields and sections are completed, save your changes. You can also choose to download the form, print it, or share it as needed.

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Case notes must include the name of the client, the date and time of the meeting or visit as well as the location of the meeting. If the encounter with the client occurred via phone, the case note must include whether or not the client was contacted or if the client made contact.

At least five (5) years of full-time employment experience working with an individual with SMI, SED, or SUD and a co-occurring chronic or complex physical health condition; 2. Successful completion of a department approved targeted case management training within six (6) months of employment as a case manager; and 3.

Targeted Case Management (TCM) is a set of services provided to a Target Population that helps our clients gain access to needed medical, clinical, social and educational services to improve the quality of their lives.

908 KAR 2:065. Community transition for individuals with serious mental illness.

Medicaid Mental Health Targeted Case Management services provide case management to adults with a serious mental illness and children with a serious emotional disturbance to assist them in gaining access to needed medical, social, educational, and other services.

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