LOUISIANA Community Mental Health Services Block Grant ...

Note: For purposes of medical eligibility for Medicaid services, the child/youth must meet the
criteria for diagnosis as contained in Item 4 of the Diagnosis Section below; Age and Disability must
be met as described below; Duration must be met as follows: Impairment or patterns of inappropriate
behavior which have/has persisted for at least three months and will persist for at least a year.
Age: Under age 18
Diagnosis: Must meet one of the following:
1. Exhibit seriously impaired contact with reality, and severely impaired social,
academic, and self-care functioning, whose thinking is frequently confused, whose
behavior may be grossly inappropriate and bizarre, and whose emotional reactions
are frequently inappropriate to the situation; or,
2. Manifest long-term patterns of inappropriate behaviors, which may include but are
not limited to aggressiveness, anti-social acts, refusal to accept adult requests or
rules, suicidal behavior, developmentally inappropriate inattention, hyperactivity,
or impulsiveness; or
3. Experience serious discomfort from anxiety, depression, or irrational fears and
concerns whose symptoms may include but are not limited to serious eating and/or
sleeping disturbances, extreme sadness, suicidal ideation, persistent refusal to
attend school or excessive avoidance of unfamiliar people, maladaptive dependence
on parents, or non-organic failure to thrive; or
4. Have a DSM-IV (or successor) diagnosis indicating a severe mental disorder, such
as, but not limited to psychosis, schizophrenia, major affective disorders, reactive
attachment disorder of infancy or early childhood (non-organic failure to thrive), or
severe conduct disorder. This category does not include children/youth who are
socially maladjusted unless it is determined that they also meet the criteria for
emotional/behavior disorder.
Disability: There is evidence of severe, disruptive and/or incapacitating functional limitations of
behavior characterized by at least two of the following:
1. Inability to routinely exhibit appropriate behavior under normal circumstances;
2. Tendency to develop physical symptoms or fears associated with personal or
school problems;
3. Inability to learn or work that cannot be explained by intellectual, sensory, or
health factors;
4. Inability to build or maintain satisfactory interpersonal relationships with peers
and adults;
5. A general pervasive mood of unhappiness or depression;
6. Conduct characterized by lack of behavioral control or adherence to social norms
which is secondary to an emotional disorder. If all other criteria are met, then
children determined to be "conduct disordered" are eligible.
Duration: Must meet at least one of the following:
1. The impairment or pattern of inappropriate behavior(s) has persisted for at least one
year;
2. There is substantial risk that the impairment or pattern or inappropriate behavior(s)
will persist for an extended period;
3. There is a pattern of inappropriate behaviors that are severe and of short duration.
PART C LOUISIANA FY 2011 PAGE 228
SECTION III: ADULT & CHILD/ YOUTH PLAN – CRITERION 2
MENTAL HEALTH SYSTEM DATA EPIDEMIOLOGY - INCIDENCE & PREVALENCE ESTIMATES