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Commonwealth's Counties

Changes considered for placement of children in residential care

The Department of Medical Assistance Services (DMAS) recently announced regulatory changes to the process by which Medicaid-eligible children with behavioral health issues are placed in Residential Treatment Facilities. Under the new process, which will begin December 1, admission for all Medicaid-funded placements for residential treatment will be coordinated by an Independent Assessment, Certification and Coordination Team (IACCT).

The IACCT will assess the child’s needs and certify the need for residential treatment, if appropriate. Localities will have the option to contract with Magellan (the Behavioral Health Administrator for DMAS) to serve as the IACCT through their local Community Policy and Management Teams, for which they would receive reimbursement from Magellan.

DMAS is strongly encouraging counties to participate and is asking for localities to indicate by October 14 whether they wish to serve as the contracted IACCT. If a locality opts not to participate, DMAS will work with the local Community Services Board or with a network of private providers to convene the IACCT.

This proposal represents a significant change to the residential treatment admissions process and local Children’s Services Act (CSA) coordinators have raised many questions about how this new process would work, including concerns about the required deadlines for the IACCT to complete an assessment and the role of the physician member of the IACCT. There are also questions about how the IACCT will work with the existing Family Assessment and Planning Team process in localities that choose not to contract with Magellan.

DMAS staff have provided a fact sheet, which is intended to provide more details on the new IACCT process. DMAS staff have also provided an email address – – to which additional questions may be directed; DMAS plans to make answers to frequently asked questions available on a periodic basis.

VACo staff will continue to participate in discussions about this new process with DMAS staff and with local CSA staff as localities assess whether to take on the IACCT role.

VACo Contact: Katie Boyle

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