Community Services Division (CSD) - Provider Learning Collaboratives

Mental Health Group Homes

Contact: Jennifer Singh, Jennifer.Singh@ct.gov

By Federal Law, a state’s Medicaid program must offer medical assistance for certain basic services such as inpatient hospital, outpatient hospital, laboratory and x-ray, physicians’ and dentists services, home health services and pregnancy related services. The state and the federal government share the cost of these mandatory services.

States may also receive Federal matching funds to provide certain optional services thereby relieving some of the financial burden on the state. Rehabilitative services in community settings are an example of such an optional service. These federal funds are paid on a fee-for-service basis directly to providers as well as matching funds to the State of Connecticut. All optional services must be deemed "medically Necessary" for living successfully in the community.


Medical Necessity - Federal Definition

“Any medical or remedial service ... for the maximum reduction of physical or mental disability and restoration of the individual to the best possible functional level.”

The Local Mental Health Authority (LMHA) has the responsibility for determining medical necessity* and developing the Master Treatment Plan...

* note:

Medical Necessity for the purpose of...


Group Home Mental Health Rehabilitation – CT State Plan Amendment

Medicaid Rehab Option services are delivered in Private Non-Medical Institutions...

Access to mental health group home rehabilitative services is provided...


Mental Health Group Home Provider Qualifications

Participating facilities must be licensed...

The facility director will hold a bachelors degree...

As a condition of certification...


Residential Rehabilitation Services

Services contained in a written plan of care...

Rehabilitative services include the following:

  • Behavior management training and intervention
  • Supportive counseling...
  • Psycho-educational groups...
  • Teaching, coaching and assisting with daily living skills...
  • Assistance in developing skills...
  • Support with connecting individuals...
  • Health education...
  • Other rehabilitative supports...

In addition, the facility provider shall conduct ongoing assessment...


Exclusions to Residential Rehabilitation Services

  • Services and programs that are solely recreational
  • Social events
  • Academic education
  • Job training and vocational services
  • Case management
  • Case coordination