Community Support Team Service Update

Tuesday, November 5, 2019

The Medicaid State Plan Amendment (SPA) was approved by the Centers for Medicare & Medicaid Services with an effective date of Oct. 1, 2019. The clinical coverage policy was posted on Oct. 10, 2019 for an additional 15-day public comment period. Following the 15-day public comment period, the final Community Support Team (CST) policy will be posted with an effective date of Nov. 1, 2019.

CST Policy changes are as follows:

  • Team composition has changed from three staff positions to four staff positions.
  • Team composition includes:
    • One full-time equivalent (FTE) dedicated team leader who is a licensed professional (psychologist, psychological associate, clinical social worker [LCSW or LCSW-Associate], professional counselor [LPC or LPC-Associate], marriage and family therapist or dually licensed clinician)
    • One FTE dedicated team member who is a licensed substance abuse professional (certified clinical supervisor, clinical addiction specialist [LCAS or LCAS-Associate], or a certified substance abuse counselor)
    • Two FTE team members who are qualified professionals, associate professionals, paraprofessionals or NC certified peer support specialist (NCCPSS) (These positions shall be filled by no more than four individuals.)
  • Expectation that if individual needs the support of a peer that they will be referred to a team that has a peer
  • Ratio is now 12:1 beneficiary/staff with a team maximum of 48 (previously 15:1 with a team maximum of 45)
  • Functional assessment and housing assessment are now required to be completed.
  • 36 unmanaged units for an initial 30-calendar day passthrough to engage the individual early in treatment. Passthrough is available once per episode of care in a state fiscal year.
  • Permanent supportive housing (PSH) components added to the service include:
    • Assist beneficiary with housing search including engaging landlords to rent to beneficiaries and writing reasonable accommodation letters;
    • Assist connecting beneficiaries to financial and in-kind resources to set up and maintain their household
    • Prevent and mitigate housing crises including being a point of contact for landlord concerns;
    • Assist with rehousing beneficiaries if they are no longer able to stay in their unit due to eviction or risk of eviction;
    • Assist in developing daily living skills to stabilize and maintain housing
  • 15 hours of PSH training is required per staff person.
GDIT, (800) 688-6696