Crisis Services – Innovations

​​​​​​For full service definition information click here to the Clinical Coverage Policy​

Crisis Services are a tiered approach to support waiver participants when crisis situations occur that present a threat to the participant's health and safety or the health and safety of others. These behaviors may result in the participant losing his or her home, job, or access to activities and community involvement. Crisis Services are an immediate intervention available 24 hours per day, 7 days per week to support the person ​who is primarily responsible for the care of the participant. Crisis Services are provided as an alternative to institutional placement or psychiatric hospitalization.

Intended Population

  • This is a service offered under the NC Innovations Waiver. This service is available to any NC Innovations waiver participants receiving provider directed services that experience a crisis that presents a health and safety risk.

Best Practices

Outcomes

  • Core Expected Outcomes

  • Improvement in CQL Personal Outcomes Measures

  • Transition from crisis services to appropriate services

  • Reduction in number of institutional placements

  • Reduction number of psychiatric hospitalizations

Management Approach

  • Core Management Strategies

  • Crisis Services are billed as three separate interventions of increasing intensity:

    • Primary Crisis Response

    • Crisis Behavioral Consultation

    • Out of Home Crisis
  • Crisis Services will be authorized in 14 calendar day increments. In situations requiring Crisis Services in excess of 14 calendar days, Cardinal Innovations must approve the request based on review of a transition plan that details the transition of the individual from crisis support to other appropriate services.

  • Providers will be monitored through clinical review activities that focus on utilization patterns and clinical appropriateness of service.

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