Early Intensive Development and Behavioral Intervention Manual

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Early Intensive Development and Behavioral Intervention Manual

EIDBI Benefit Policy Manual Resources Comparison of CTSS and EIDBI

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Comparison of Children’s Therapeutic Services and Supports (CTSS) and EIDBI

Page updated: 6/2/21

Category of comparison	Children’s Therapeutic Services and Supports (CTSS)	Early Intensive Developmental and Behavioral Intervention (EIDBI) benefit
Legal authority	Minn. Stat. §256B.0943	Minn. Stat. §256B.0949, Centers for Medicare & Medicaid Services (CMS)-approved state plan amendment (PDF)
Background	The 2003 Minnesota Legislature passed Minn. Stat. §256B.0943 to create Children’s Therapeutic Services and Supports (CTSS) in 2003. It has been revised several times.	The 2013 Minnesota Legislature passed Minn. Stat. §256B.0949 to create the Early Intensive Developmental and Behavioral Intervention (EIDBI) benefit for children up to age 18 with autism spectrum disorder (ASD). Later amendments expanded eligibility to include people up to age 21 with ASD or a related condition. CMS approved a revised state plan amendment for the EIDBI benefit in December 2017 (PDF) and other revisions in December 2018 (PDF) and June 2019 (PDF).
Overview	CTSS is a Minnesota Health Care Program (MHCP) benefit. It provides a flexible package of mental health services for children who need varying therapeutic and rehabilitative levels of services. CTSS psychiatric rehabilitation services for children combine both: · Psychotherapy to address internal psychological, emotional and intellectual processing deficits · Skills training to restore personal and social functioning to the proper developmental level. CTSS addresses conditions of emotional disturbance that impair and interfere with a person’s ability to function independently. Services are designed to either: · Restore a child to an age-appropriate developmental track that had been disrupted by a psychiatric illness · Help the child self-monitor, compensate for, cope with, counteract or replace psychosocial skills, deficits or maladaptive skills developed over the course of a psychiatric illness.	EIDBI is a Minnesota Health Care Program (MHCP) benefit. It provides medically necessary, early intensive intervention for people with ASD and related conditions, as well as: · Educates, trains and supports their parents and families · Promotes people’s independence and participation in family, school and community life · Improves long-term outcomes and the quality of life for people and their families. Definition of related condition A related condition is a condition that is closely related to ASD and: 1. Is severe and chronic 2. Requires treatment or services similar to those required for a person with ASD 3. Results in a person’s substantial functional limitations in three core developmental domains of ASD: · Social interaction · Non-verbal/social communication · Restrictive, repetitive behaviors 4. May include limitations or high levels of need in one or more of the following related developmental domains: · Interfering behaviors · Cognitive functioning · Expressive communication · Receptive communication · Safety and level of support needed · Self-care · Sensory processing.
Eligibility	A person is eligible to receive CTSS services if he or she meets all of the following criteria: 1. Is younger than age 21 2. Has a standard or extended diagnostic assessment (DA) that documents either: · A primary diagnosis of an emotional disturbance for children younger than age 18 · Mental illness for young adults age 18 through 20 Note: A mental health professional or clinical trainee must complete the diagnostic assessment used to establish eligibility for CTSS within 365 days before CTSS services begin. 3. Meets medical necessity for CTSS 4. Has a completed Child and Adolescent Service Intensity Instrument (CASII) or Early Childhood Service Intensity Instrument (ECSII) 5. Has a completed and signed individual treatment plan (ITP) that: · Documents specific goals and objectives for CTSS services · Is signed by the supervising mental health professional and the parent or guardian before the person receives services.	A person is eligible to receive EIDBI services if he or she meets all of the following criteria: · Is younger than age 21 · Has ASD or a related condition · Has had a comprehensive multi-disciplinary evaluation (see EIDBI – CMDE) that establishes medical necessity for EIDBI services, completed by a CMDE provider (see MHCP – Provider directory) · Is enrolled in Medical Assistance (MA), MinnesotaCare, Minnesota Tax Equity and Fiscal Responsibility Act (TEFRA) or other qualifying health plans.
Covered services	CTSS covers: · Psychotherapy with the person or family member (or both), family, group and psychotherapy for crisis (see MHCP Provider Manual – Psychotherapy and MHCP Provider Manual – Psychotherapy for Crisis) · Skills training with the person, family or group · Crisis assistance · Treatment plan development and review · Administering and reporting standardized measures. Optional services also may be offered by some providers, including: · Mental health behavioral aide services · Children’s day treatment (i.e., a combination of psychotherapy and skills training). For more information about the CTSS covered services, see MHCP Provider Manual – CTSS. Telemedicine is an option for some CTSS services. For more information, see MHCP Provider Manual – Telemedicine Delivery of Mental Health Services Only eligible provider types may perform each service. For more information, see MHCP Provider Manual – CTSS – Eligible Providers.	EIDBI covers: · Comprehensive multi-disciplinary evaluation (CMDE) · Individual treatment plan (ITP) development and progress monitoring · Coordinated care conference · Intervention – group and individual · Intervention observation and direction · Family or caregiver training and counseling · Travel time. For more information about the EIDBI covered services, see EIDBI – Services. Telemedicine is an option for some EIDBI services. For more information, see EIDBI – Telemedicine services. Only eligible provider types may perform each service. For more information, see EIDBI – Overview of EIDBI providers.
More information	DHS encourages providers to take the self-paced, online coordinating services and supports for a child with ASD or a related condition course. This course helps participants differentiate between EIDBI, CTSS and other services for children with ASD and related conditions. If you have questions about CTSS, contact dhs.ctss@state.mn.us. To locate a CTSS provider, see Current CTSS Community Providers (PDF). If you receive MHCP fee-for-service, contact the MHCP Member Help Desk by calling 651-431-2670. For primary insurance questions, contact the member help desk using the information on the back of your healthcare card.	DHS encourages providers to take the self-paced, online coordinating services and supports for a child with ASD or a related condition course. This course helps participants differentiate between EIDBI, CTSS and other services for children with ASD and related conditions. If you have questions about the EIDBI benefit, submit an inquiry using the MN Autism Resource Portal Contact Form. To locate a CMDE or EIDBI provider, see MHCP – Provider Directory. If you receive MHCP fee-for-service, contact the MHCP Member Help Desk by calling 651-431-2670. For primary insurance questions, contact the member help desk using the information on the back of your healthcare card.

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