MAD pays for coverage for permanent supportive housing
pre-tenancy and tenancy support services (PSH-TSS) to an eligible recipient
enrolled in a managed care organization to facilitate community integration and
contribute to a holistic focus on improved health outcomes, to reduce the
negative health impact of precarious housing and homelessness, and to reduce
costly inpatient health care utilization. Services include, but are not limited
to, pre-tenancy services including individual housing support and crisis
planning, tenancy orientation and landlord relationship services as well as
tenancy support services to identify issues that undermine housing stability
and coaching, education and assistance in resolving tenancy issues for an
eligible recipient who has a serious mental illness and is enrolled in a
medicaid managed care organization on, or after, July 1, 2019. The effective
date will be July 1, 2019, or as otherwise approved by the centers for medicare
and medicaid services (CMS).
A.
Eligible providers and practitioners:
(1) Any clinic, office or agency providing
permanent supportive housing under the human services department's linkages
program administered by the behavioral health services division.
(2) Behavioral health practitioners employed
or contracted with such facilities including:
(a) behavioral health professional licensed
in the state of New Mexico; and
(b)
certified peer support workers or certified family peer support
workers.
B.
Coverage criteria:
(1)
Enrollment in the linkages permanent supportive housing program.
(2) An assessment documenting serious mental
illness.
C.
Eligible recipients: Individuals with serious mental
illness.
D.
Covered
services:
(1) Pre-tenancy services,
including:
(a) screening and identifying
preferences and barriers related to successful tenancy;
(b) developing an individual housing support
plan and housing crisis plan;
(c)
ensuring that the living environment is safe and ready for move-in;
(d) tenancy orientation and move-in
assistance;
(e) assistance in
securing necessary household supplies; and
(f) landlord relationship building and
communication.
(2)
Tenancy support services, including:
(a) early
identification of issues undermining housing stability, including member
behaviors;
(b) coaching the member
about relationships with neighbors, landlords and tenancy conditions;
(c) education about tenant responsibilities
and rights;
(d) assistance and
advocacy in resolving tenancy issues;
(e) regular review and updates to housing
support plan and housing crisis plan; and
(f) linkages to other community resources for
maintaining housing.
E.
Duration: The PSH-TSS
benefit is available to an eligible member for the duration of the member's
enrollment in a linkages program, ceasing when the client leaves the
program.
F.
Reimbursement: See Subsection H of
8.321.9 NMAC for MAD behavioral
health general reimbursement requirements. See the BH policy and billing manual
for reimbursement specific to PSH-TSS. These services do not include tenancy
assistance in the form of rent or subsidized housing.
Notes
N.M. Code R. §
8.321.2.36
Adopted by
New
Mexico Register, Volume XXX, Issue 23, December 17, 2019, eff.
1/1/2020, Adopted by
New
Mexico Register, Volume XXXII, Issue 15, August 10, 2021, eff.
8/10/2021
