Florida Medicaid Mental Health Targeted Case Management Services:

What is the purpose of Florida Medicaid Mental Health Targeted Case Management Services?

The purpose of Florida Medicaid Mental Health Targeted Case Management (TCM) Services is to assist individuals (recipients) in gaining access to needed medical, social, educational, and other services. 

What is the goal of TCM?

The primary goal of TCM is to optimize the functioning of recipients who have complex needs by coordinating the provision of quality treatment and support services in the most efficient and effective manner. Services and service frequency should accurately reflect the individual needs, goals, and abilities of each recipient and must not simply reflect the Medicaid maximum allowable for the service.

Recipient Eligibility and Certification Requirements:

To receive TCM, the recipient must be Florida Medicaid eligible on the date of service and must be certified as meeting the eligibility criteria for a specific target group below:

• Group # 1: Children’s mental health targeted case management for recipients’ birth through 17 years.
• Group # 2: Adult mental health targeted case management for recipients aged 18 years and older.
• Group # 3: Intensive case management team services for recipients aged 18 years and older.

Exceptions to Recipient Eligibility Requirements:

The following Medicaid recipients may receive TCM for up to a maximum of 30 days without meeting the eligibility criteria for a specific target group above.:

• A recipient who has been referred by Medicaid’s contracted utilization management services vendor after a denied admission to or discharge from an inpatient psychiatric unit;
• A recipient who has been admitted to an inpatient psychiatric unit; or
• A recipient who has been identified by Medicaid’s contracted utilization management services vendor as high-risk.

What is Targeted Case Management (TCM) for Children at Risk of Abuse and Neglect?

Medicaid TCM for children at risk of abuse and neglect services provide case management to recipients whose parent(s):

• Are unable to meet their basic needs.
• Has inadequate income or housing.
• Is socially isolated or has limited natural support.
• Is a past or current victim of domestic violence.
• Has a history of mental illness requiring treatment or hospitalization or some degree of mental concern.
• Used harmful substances upon knowledge of pregnancy.
• Received little to no prenatal care, or is the subject of a report of abuse and neglect made to the Department of Children and Families that did not result in a court order into foster care, shelter care, or protective supervision.

The service assists recipients with gaining access to medical, social, educational, and other services as required.

Our Behavioral Health Case Managers and Supervisors are here to help!

Our Certified Behavioral Health Case Managers, (CBHCM) and Supervisors, (CBHCMS) are all certified by the Florida Certification Board they offer services, and support to patients and families to help them solve real-life problems related to serious health conditions. We help patients understand their choices to make healthy decisions for a strong recovery.

To get started, please feel free to contact OIT Margaretha A. DeJesus at mdejesus@usfdrc.org or call 1-321-332-7100, ext. 563. To expedite fill out this form below. We're here for you every Monday through Friday 9:00 AM to 5:00 PM. Eastern Time We're closed for major holidays.

To expedite fill out this form below:

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