When a foster child or youth is experiencing serious or severe emotional problems, EPSDT specialty mental health services are available.
For children and youth who are under 21 years of age and have full-scope Medi-Cal coverage, EPSDT specialty mental health services are available in addition to other Medi-Cal EPSDT services such as medically necessary health, vision and dental care. For children and youth with serious emotional disturbances (SED), specialty mental health services under EPSDT are provided as outpatient services and may include, but aren’t limited to, assessment, collateral, individual or group therapy, crisis intervention and stabilization, day treatment intensive services, medication support, and case management. Services to EPSDT beneficiaries may also include services directed toward substance abuse issues if such services are necessary to the attainment of the beneficiary’s mental health treatment goals.
Therapeutic Behavioral Services (TBS) are additional services available under the EPSDT benefit. TBS allows for the provision of intensive one-to-one services for children and youth with SED who are experiencing a stressful transition or life crisis. TBS is not a stand-alone service and must be provided as a support service for other specialty mental health services when additional short-term support is needed to prevent placement in a group home of Rate Classification Level (RCL) 12 through 14 or a locked facility for the treatment of mental health needs. TBS may also be provided to enable a transition from any of those levels to a lower level of residential care.
EPSDT and TBS brochures may be found in DMH Letter No.: 01-07. Also see general information on EPSDT/TBS mental health services.
For all EPSDT specialty mental health services including TBS, the appropriate County Mental Health Plan (MHP) must assess and decide on the mental health services that are medically necessary to correct or ameliorate the child or youth’s condition. To find the person for your County MHP, go to contacts.
Ombudsman for Medi-Cal Mental Health Services
The office of the Ombudsman for Medi-Cal Mental Health Services was created to help caregivers, youth and others find their way through the mental health system. Staff in this office can provide information, explain rights and choices, help solve problems, assist in communication, request information, and make referrals to others. This office can be reached during weekdays at 1-800-896-4042 or for TTY at 1-800-896-2512. You can also send an email to: Ombudsmn@dmhhq.state.ca.us.
For more information about mental health services,
call the Office of the Foster Care Ombudsman