This crosswalk was developed by the Michigan Department of Health & Human Services, Division of Mental Health Services to Children & Families.
The Technical Requirement for children with serious emotional disturbance (SED) (rev. 11/5/15) is regarding: 1) Medicaid eligibility criteria for children with serious emotional disturbance; and 2) establishing General Fund priority for mental health services for children with serious emotional disturbance. The technical requirement establishes criteria for determination of serious emotional disturbance for children birth to age 18 years of age. It includes specific criteria for young children, birth to age 47 months. Young children meeting the criteria delineated in this document are considered to have a serious emotional disturbance, as defined in the Michigan Mental Health Code. The criteria for establishing serious emotional disturbance includes diagnosis, functional limitation, and duration. For infants and toddlers (birth to 47 months), the diagnosis criteria is delineated and includes that an “infant or toddler has a mental, behavioral, or emotional disturbance sufficient to meet the diagnostic criteria specified in the most recent diagnostic and statistical manual of mental disorders published by the American Psychiatric Association consistent with the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: Revised Edition (see linked crosswalk below) that has resulted in functional impairment.”
For Medicaid children, once an eligibility determination has been made based on the criteria delineated in this document, selection of services is determined. Determination of services should also be made based on medical necessity criteria, and, where applicable, the service-specific criteria, coverage policy and decision parameters contained in the most recent version of the Medical Services Administration’s Medicaid Policy Manual. However, decisions regarding access/eligibility should not be based on medical necessity criteria or service-specific criteria since these decisions are a separate and subsequent process to eligibility determinations.
If you have a question regarding the Technical Requirement for young children, birth to 47 months or 4 through 6 years of age, please contact Mary Ludtke, MDHHS-Mental Health Services to Children and Families at Ludtkem@michigan.gov or (517) 241-5769.