1. Individualized Service Agreements (ISA)
State of Alaska
Division of Behavioral Health
Policy and Planning

2. Individualized Service Agreement
What is it -
A provider Agreement with the State of Alaska for the purpose of providing individual, specialized services for severely emotionally disturbed (SED) children.

3. Individualized Service Agreements (ISA) – Funding Process
Client Eligibility
A resident of the state
Under 22 years of age
Been assessed by a MH professional and meets criteria for SED
Is at imminent risk of being removed from the home
Been assessed to meet residential level of care
Has been approved by DHSS for services

4. Individualized Service Agreements Examples of Acceptable Uses
Non-Medicaid services such as:
For Non-MC recipients – all MC covered services
Services that allow recipient to maintain at least restrictive level of care
Services that would normally be covered by Medicaid for non-resourced recipients
Room and board for non-custody kids in level 2-4 BRS facilities, continued need reviewed every 90 days.
Vocational rehabilitation
Rent including utilities not to exceed 90 days
Start up costs for individual living settings
Specialized treatments – private practitioners physician clinic services (Must Contract thru Community Behavioral Health center CBHC).
Transportation
Parenting classes

5. Individualized Service Agreements Examples of Acceptable Uses (cont.)
Care coordination for non Medicaid recipients or case management?
Case management for recipient 90 days (60 days payable) prior to discharge from inpatient facilities. (Last 30 days should be billable to Medicaid)
Respite
Expert consultations e.g. sexual acting out,
Limited home modifications necessary to maintain child in home
Life management skills
After school programs
Family home assessment
Social activities
Mentoring
Tuition
Other services determined to be clinically appropriate.

6. Individualized Service Agreements Non-Acceptable Uses:
Individualizes services dollars will not pay for or augment:
foster care rates
substance abuse treatments
Capital Funding/substantial home renovations

7. Individualized Service Agreements (ISA)
Other billing mechanisms must be utilized
Medicaid
Private Insurance
5% Set Aside Funds for CBHCs with SED Grants*
* SED Grants do not need to be “spent down” prior to receiving ISA funds

8. Individualized Service Agreements (ISA) – Funding Process
Service provider must be a CBHC Medicaid provider.
CBHC may contract with other agencies for identified services.

9. Individualized Service Agreements (ISA) – Funding Process
Providers complete the Referral & Billing Form which includes requested services, # of unit(s) and costs of services (for initial referral and every 90 days)

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11. Individualized Service Agreements (ISA) – Funding Process
Referral & Billing Form faxed to DBH UR staff along with initial Treatment Plan or quarterly Treatment Plan Review

12. Individualized Service Agreements (ISA) – Funding Process
Billing – submitted by provider every 30 days to DBH
For initial funding requests, provider submits Treatment Plan to DBH UR staff
For continued funding requests, provider submits quarterly Treatment Plan Review to DBH UR staff

13. Individualized Service Agreements (ISA) –Website to download Agreement

14. Individualized Service Agreements (ISA) – Utilization Review Staff
Southeast Region and Matsu Valley - Reta Sullivan (907) /
 Northern Region- Judy Helgeson (907)
Anchorage- Maureen McGlone (907)
Southcentral Region (excluding Matsu)- Anne Gibson (907) /