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Children's Mental Health Wraparound Program

Child Mental Health Wraparound (CMHW) Program

Indiana Medicaid offers coverage for the Child Mental Health Wraparound (CMHW) home and community-based services (HCBS). The CMHW HCBS program provides services to youth, ages 6-17, who have a diagnosis of a serious emotional disturbance (SED).  A person-centered treatment plan is built upon the member and family's strengths to identify the following:

  • The unique needs of the CMHW member
  • Services and strategies that assist the member and family in achieving more positive outcomes in their lives

Who is eligible for CMHW?

You must meet HCBS eligibility and Medicaid eligibility guidelines in order to be eligible for CMHW services.  To be eligible you must:

  • Must be 6 through 17 years of age
  • Must be eligible for Indiana Medicaid
  • Must have two or more Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Text Revision (TR) diagnoses that are not considered excluded

The applicant must also demonstrate a level of need by meeting the following criteria:

  • Receive a score of 4 or higher on the DMHA-approved assessment tool
  • Have one or more of the following behavioral or emotional needs
    • Adjustment to trauma
    • Psychosis
    • Debilitating anxiety
    • Conduct problems
    • Sexual aggression
    • Fire-setting
  • Demonstrate a significant need in at least one of the family or caregiver areas that results in a negative impact on the applicant's mental illness:
    • Mental health
    • Supervision issues
    • Family stress
    • Substance abuse

Excluded diagnoses:

You will not qualify for CMHW if you meet one of these diagnoses:

  • You have a primary diagnosis of a Substance Use Disorder
  • You have a diagnosis of a Pervasive Developmental Disorder
  • You have a primary diagnosis of an Attention Deficit Hyperactivity Disorder
  • You have a primary diagnosis of  an intellectual disability/developmental disabilities, such as Autism Spectrum Disorder
  • You have a dual diagnosis of serious emotional disturbance and intellectual disabilities
  • You reside in an institutional setting

It is also DMHA policy to exclude any youth who is at imminent risk of harm to self or others. Any youth identified as not able to feasibly receive intensive community-based services without compromising his or her safety, or the safety of others, will be referred to a facility capable of providing the level of intervention or care needed to keep the youth safe. After the youth has been deemed safe to return home to community-based treatment, CMHW services may be applied for at that time.

COVERED SERVICES:

The CMHW services available to the eligible members include:

  • Wraparound Facilitation
  • Habilitation
  • Respite Care
  • Family Support and Training for the Unpaid Caregiver

HOW TO APPLY FOR CMHW

When should I apply?

It is helpful to apply as soon as you identify a need for services.

Where Do I Apply?

First, go to a local access site. You must also apply for Medicaid.  You can learn more about applying for Medicaid by going to the Apply for Medicaid webpage.

For more information on CMHW, please visit FSSA's CMHW webpage or email at DMHAYouthServices@fssa.in.gov.

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