Child Mental Health Wraparound Program
Child Mental Health Wraparound Program
Indiana Medicaid offers coverage for the Child Mental Health Wraparound (CMHW) home and community-based services (HCBS). These services are provided to youth, ages 6-17, who have a diagnosis of a serious emotional disturbance. 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
Individuals must meet both HCBS eligibility and Medicaid eligibility guidelines in order to be eligible for CMHW services. To be eligible individuals must:
- Be 6 through 17 years of age
- Be eligible for Indiana Medicaid
- Have two or more Diagnostic and Statistical Manual of Mental Disorders Text Revision diagnoses that are not considered excluded
- Demonstrate a level of need by meeting the following criteria:
- Receive a score of 4 or higher on the Division of Mental Health and Addiction (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
Individuals will not qualify for CMHW if they meet one of these excluded diagnoses:
- Have a primary diagnosis of a Substance Use Disorder (SUD)
- Have a diagnosis of a Pervasive Developmental Disorder
- Have a primary diagnosis of an Attention Deficit Hyperactivity Disorder (ADHD)
- Have a primary diagnosis of an intellectual disability/developmental disabilities, such as Autism Spectrum Disorder
- Have a dual diagnosis of serious emotional disturbance and intellectual disabilities
- Reside in an institutional setting
- Any youth who is at imminent risk of harm to self or others.
Note: Any youth identified as not able to feasibly receive intensive community-based services without compromising their own 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:
In addition to Indiana Medicaid covered-services, individuals receiving CMHW services are eligible for the following:
- Wraparound facilitation
- Habilitation
- Respite care
- Family support and training for the unpaid caregiver
Member Information
To apply, you must first submit a referral to the access site.
You must also apply for Medicaid. You can learn more about applying for Medicaid by going to the Apply for Coverage webpage.
- For more information on CMHW, please visit FSSA's CMHW webpage or email DMHAYouthServices@fssa.in.gov.
Provider Information
CMHW services may be delivered only by a DMHA-approved agency or individual provider according to qualifications and standards for the specific service the agency or individual provider is applying to provide. For more information about becoming a DMHA-approved CMHW provider, visit the DMHA's Provider Information page.
DMHA-approved providers must also be enrolled with the Indiana Health Coverage Programs as a mental health care provider with the CMHW specialty. Refer to the Become a Provider webpage for more information.
Additional provider resources regarding CMHW services are available at the following links:
- DMHA CMHW Services web page
- Child Mental Health Wraparound guide
- DMHA Child Mental Health Wraparound Services provider reference module
- Home and Community-Based Services Billing Guidelines provider reference module