Individual Eligibility for the Program

Section 148.820  Individual Eligibility for the Program a)         For the purposes of this Subpart, only Medicaid eligible individuals 21 through 64 years of age, with a serious mental illness, who present at a participating or partnering hospital with suicidal or homicidal thoughts or gestures, or who are a danger to self or others, will be eligible to participate.  Individuals enrolled in a care coordination program [305 ILCS 5/5-30], as well as those individuals who have Medicare coverage, are excluded from participation. b)         Participation shall also be limited to the maximum number of IMD admissions funded by CMMS and the number of deflections to community services before reaching the maximum IMD number funded as provided in the supplemental provider agreement.