Agency: California Department of Consumer Affairs, including licensing boards: 

• CA Board of Registered Nursing
• Dental Board of CA
• CA Dental Hygiene Board
• Physical Therapy Board of CA
• CA Board of Pharmacy
• CA Physician Assistant Board
• Osteopathic Medical Board of CA
• CA Veterinary Medical Board

The California Recovery Program is a confidential program that provides monitoring and rehabilitation of healthcare professionals whose ability to practice safely has been affected by the use of drugs or alcohol, and in some cases, by mental illness. Our primary mission is equal to that of the Boards’, which is to protect the public and return the participant to safe, professional practice.

Substance use disorder is recognized by experts as a chronic, relapsing disease. Much like cardiac disease, diabetes or asthma, it is a permanent condition, and when treated and in remission, approximately 65 to 70% of individuals relapse. Treatment followed by supportive monitoring, such as is offered by the Recovery Program, reduces the risk of relapse to less than 20%.

The Recovery Program is not a treatment program and is not a program of discipline. The Recovery Program is a program of support, monitoring, and accountability.

• Access tools and resources for the California Recovery Program

Agency: State of Connecticut, Department of Social Services

We partner with the Department of Social Services to perform Preadmission Screening and Resident Review (PASRR) for individuals who are applying to, or residing in, Medicaid-certified nursing homes.

The primary goal of this federally mandated assessment is to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities or developmental disabilities. PASRR also works as a critical function to help match individuals with the care and services they need.

Resources: 

• Access tools and resources for conducting PASRR assessments in Connecticut
• Learn more about PASRR 
• Help people understand what to expect of their PASRR assessment

Agency: State of Connecticut, Department of Social Services

In addition to PASRR assessments, we also perform assessments for other specialty waiver programs. All onsite, face-to-face evaluations on individuals residing in Connecticut, are performed by Connecticut-based licensed clinicians who have extensive experience in the field of mental health and other disabilities and who are fully credentialed and comprehensively trained.

With each assessment performed, we monitor performance, measure compliance standards and meticulously review each assessment for accuracy and thoroughness. Ongoing feedback is given to the professionals to address any concerns, maintain fidelity, and enhance assessment quality.

Agency: Delaware Health and Social Services - Medicaid and Medical Assistance (DMMA)

We partner with the Department of Health and Social Services, Division of Medicaid and Medical Assistance (DHHS/DMMA) to perform Preadmission Screening and Resident Review (PASRR) for individuals who are applying to, or residing in, Medicaid-certified nursing facilities (NFs), managed through a web-based platform.

The primary goal of this federally mandated assessment is to determine whether the facility is the appropriate placement for individuals with Serious Mental Illness (SMI) or Intellectual/Developmental Disabilities (I/DD). PASRR also works as a critical function to help match individuals with the care and services they need.

Resources:

• Access tools and resources for conducting PASRR assessments in Delaware
• Learn more about PASRR
• Help people understand what to expect of their PASRR assessment

Agency: Illinois Department of Healthcare and Family Services (HFS) 

We have contracted with the State of Illinois Department of Healthcare and Family Services (HFS) to manage comprehensive assessment processes for various screening and assessment services including:

• Preadmission Screening and Resident Review (PASRR) Level I screens and completing Level II Serious Mental Illness (SMI) evaluations for individuals applying to, or residing in, Medicaid-certified nursing facilities. The federally mandated PASRR screening and assessment are used to determine whether the nursing facility is the appropriate placement for individuals with mental illness, intellectual disabilities, or developmental disabilities. PASRR also works as a critical function to help match individuals with the care and services they need.
   
• Follow Up Visits, in-person visits scheduled between the 30th and 60th day of Nursing Facility (NF) stays for persons who have previously received a PASRR Level II Mental Health Assessment
   
• Assessment processes for all persons indicating preference for placement in a Specialized Mental Health Rehabilitation Facility (SMHRF) setting
   
• Assessment processes for all persons indicating preference for placement in a Supported Living Program (SLP) setting
   
• Colbert Dementia Review conducted to facilitate HFS compliance with Colbert Consent Decree requirements and appropriate services for Cook County residents

Resources: Access tools and supports for the Illinois SALT portfolio of services

Agency:  State of Indiana, Family and Social Services Administration

We partner with the Family and Social Services Administration to perform Preadmission Screening and Resident Review (PASRR) Level I screens, Level II MI and IDD evaluations, and Level of Care for individuals applying to, or residing in, Medicaid-certified nursing facilities.

These federally mandated assessments are used to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities or developmental disabilities. PASRR also works as a critical function to help match individuals with the care and services they need.

Resources: 

• Access tools and resources for conducting PASRR Level I and Level II MI and IDD, and Level of Care assessments in Indiana
• Learn more about Intellectual and Developmental Disabilities (IDD) Assessments
• Learn more about PASRR 
• Help people understand what to expect of their PASRR assessment

Agency: Indiana Department of Child Services (DCS) 

We have been contracted with the Indiana Department of Child Services (DCS) to manage the state’s qualified residential treatment program (QRTP) 30-day assessment services program as part of the state’s implementation of the Family First Prevention Services Act (FFPSA). Maximus staff assess eligible children referred from DCS to determine the appropriateness of receiving care in a QRTP. Staff will create individualized recommendations for the child’s care. Please continue to check back for updates and added resources in the coming weeks. Interested in working as an independent contractor assessor for the Indiana QRTP program? If you are an Indiana resident with a minimum of four years of experience working with children and adolescents with behavioral needs, as well as a bachelor’s degree in human services or a related field (licensure not required), please contact our recruiting team to learn more: Recruiting@maximus.com

Resources: 

Access tools and resources for conducting QRTP assessments in Indiana

Agency:  Iowa Department of Health and Human Services

We partner with the Department of Human Services to perform Level I and Level II onsite evaluations for the Preadmission Screening and Resident Review (PASRR) program – and have done so since 2011.

PASRR is performed on individuals who are applying to, or residing in, Medicaid-certified nursing homes. The main objective of this federally required assessment is to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities or developmental disabilities.

PASRR also works as a critical function to help match individuals with the care and services they need.

Resources: 

• Access tools and resources for conducting PASRR assessments in Iowa

Agency:  State of Maine Department of Health and Human Services, Office of Aging and Disability Services (OADS)

We manage Maine's Statewide Assessment Services Agency, which is an integrated service for assisting individuals across a range of support programs, including Long Term Care (LTC), Acquired Brain Injury (ABI), and Intermediate Care Facilities (ICF), among others.

Resources: 

• Access tools and resources for Maine's ASA Support program

The Long-Term Care (LTC) Advisory is an assessment that provides advice to the individual and family/guardian to determine if the person is eligible for possible facility admission, or in-home services funded through MaineCare or state funded home-based care programs. Individuals choosing to enter a nursing facility must have this type of assessment to comply with the State statutes unless entering under skilled care.

We perform onsite evaluations for individuals suspected of having a mental illness, through the Preadmission Screening and Resident Review (PASRR) program.

The primary goal of this federally mandated assessment is to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities or developmental disabilities. PASRR also works as a critical function to help match individuals with the care and services they need.

Resources: 

• Access tools and resources for conducting PASRR assessments in Maine
• Learn more about PASRR 
• Help people understand what to expect of their PASRR assessment

Acquired Brain Injury (ABI) is an injury to the brain that results from trauma, infection, vascular lesions, or anoxia. It can result in physical, behavioral or mental dysfunction affecting an individual’s ability to function independently. This evaluation requires a neuropsychologist evaluation and completion of the Mayo Portland Adaptability Inventory and Health and Safety tool to determine medical eligibility for specialized ABI services eith in the facility setting or at home.

Other Related Conditions (ORC) constitute Cerebral Palsy, Epilepsy, or other condition besides mental illness which found to be closely related to Intellectual Disability, resulting in impairment or general intellectual functioning or adaptive behavior, similar to that of persons with Intellectual Disabilities and requires similar treatment or services.

The State of Maine requires a Medical Eligibility Determination assessment and completion of the BMS 99 to determine an individual’s medical eligibility for services under the Other Related Conditions Waiver. The program provides community integration through existing natural supports and community relationships, such as Care Coordination, Home Support, Community Support, and Work Support.

Intermediate Care Facilities (ICF) are specialized facilities for Individuals with Intellectual/Developmental Disabilities (IDD), or other related conditions, who require care and services above the level of room and board but not that of a hospital or skilled nursing facility. Medical eligibility requires a physician certification that the person have a need for at least 8 hours of licensed nurse supervision per day. The focus of these facilities is to assist individuals to reach their maximal level of functioning capabilities, with healthcare and rehab services while providing 24 hour care.

Agency:  Office of Aging and Disability Services (OADS)

Maximus has been contracted to partner with the State of Maine Department of Health and Human Services – Office of Aging and Disability Services (OADS) to administer the Supports Intensity Scale for Adults (SIS-A) Assessments. This comprehensive planning tool measures support needs in the areas of home living, community living, lifelong learning, employment, health and safety, and social activities.

Resources: 

• Access tools and resources for conducting SIS Assessments in Maine
   
• Learn more about "A Path for ME" SIS-A Assessments
   
• Learn more about SIS

Agency: Michigan Department of Health and Human Services 

We have been contracted with the Michigan Department of Health and Human Services (MDHHS) to manage the state’s Qualified Residential Treatment Programs (QRTPs). With this partnership, our role involves the conducting of assessments to determine appropriate level of care for foster children. Continue to check back to the site often for new updates and resources.

Interested in working as an independent contractor assessor for the Michigan QRTP program?  If you are a Michigan resident with a minimum of two years of experience working with children and adolescents with behavioral diagnoses, as well as a Bachelor’s degree in human services or a related field, please contact our Recruiting team to learn more: Recruiting@maximus.com

Resources: 

• Access tools and resources for conducting QRTP assessments in Michigan

Agency:  Mississippi Division of Medicaid

We partner with the Division of Medicaid to perform Level II on-site evaluations for the Preadmission Screening and Resident Review (PASRR) program – and have done so since 2012. PASRR assessments are performed on individuals who are applying to, or residing in, Medicaid-certified nursing homes. The primary objective of this federally-mandated assessment is to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities or developmental disabilities. PASRR also works as a critical function to help match individuals with the care and services they need.

Resources: 

• Access tools and resources for conducting PASRR assessments in Mississippi
• Learn more about PASRR 
• Help people understand what to expect of their PASRR assessment

Agency: State of Montana, Department of Labor and Industry, Business Standards Division, including Licensing Boards:

• MT Board of Dentistry
• MT Board of Medical Examiners
• MT Board of Nursing
• MT Board of Pharmacy

We partner with the State of Montana, Department of Labor and Industry, Business Standards Division, and the State’s Boards of Dentistry, Medical Examiners, Pharmacy and Nursing to administer and manage a Recovery Program for licensed health care professionals.

The Montana Recovery Program is a case management program that provides monitoring and rehabilitation of healthcare professionals whose ability to practice safely has been affected by the use of drugs or alcohol, and in some cases, by mental or physical illness. Our primary mission is equal to that of the Boards’, which is to protect the public and return the participant to safe, professional practice. 

• Access tools and resources on the Montana Recovery website.

Agency: New Hampshire Department of Health and Human Services (DHHS) - Division of Children, Youth and Families (DCYF)  

We have contracted with the New Hampshire Department of Health and Human Services (DHHS) - the Division for Behavioral Health, Bureau for Children’s Behavioral Health and the Division of Children, Youth and Families (DCYF) to manage the state’s independent Comprehensive Assessment for Treatment (CAT) services program as part of the state’s implementation of the Family First Prevention Services Act (FFPSA) and the New Hampshire System of Care (SOC) for Children. The role of Maximus in this partnership is to determine the use of residential services for eligible children and youth by qualified clinicians and that established Medical Necessity will be applied through the use of a standard assessment tool, the Child and Adolescent Needs and Strengths (CANS), for all levels of residential services.

Interested in working as an independent contractor assessor for the New Hampshire CAT program?  If you are a New Hampshire resident with a minimum of two years of experience working with children and adolescents with behavioral diagnoses, as well as a Bachelor’s degree in human services or a related field, please contact our Recruiting team to learn more: Recruiting@maximus.com

Resources: 

• Access tools and resources for conducting CAT assessments in New Hampshire 

Agency:  The New York Department of Health, Office of Community Transition Services (CTS)

We partner with CTS to perform Level II onsite evaluations for individuals suspected of having a mental illness the Preadmission Screening and Resident Review (PASRR) program. PASRR assessments are performed on individuals who are applying to, or residing in, Medicaid-certified nursing homes. The primary objective of this federally-mandated assessment is to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities or developmental disabilities. PASRR also works as a critical function to help match individuals with the care and services they need.

Resources: 

• Access tools and resources for conducting PASRR assessments in New York
• Learn more about PASRR 
• Help people understand what to expect of their PASRR assessment

Maximus has partnered with the New York State Department of Health to establish the New York Independent Assessor Program (NYIAP) for New York State Medicaid consumers who want to receive personal care services or community-based long-term services and supports. NYIAP Nurse Assessors conduct conflict-free assessments of these individuals using the Community Health Assessment tool to determine whether they qualify for these services. Independent Practitioners—physicians, nurse practitioners, and physician assistants—conduct clinical appointments to determine if the individual is medically stable to receive services in the community. The information collected from the assessment and clinical appointment is used by local Departments of Social Services, Medicaid Managed Care Organizations, and Managed Long Term Care plans to develop the individual’s plan of care and make determinations regarding the services the individual may receive.

New York Medicaid Choice (NYMC) is among the largest managed care enrollment programs in the country, serving more than seven million Medicaid consumers. NYMC provides these consumers with education about how managed care works, advises them of their managed care options, and enrolls them in the health plan of their choice. NYMC is a call center- and outreach-based program that provides unbiased information to New York Medicaid recipients and helps them make the best health plan choice for themselves and their families. 

Maximus has partnered with the New York State Department of Health to establish the Children and Youth Evaluation Service (CYES) program to determine whether a child or youth is eligible for home and community-based services (HCBS) covered by Medicaid. CYES makes eligibility determinations primarily for children and youth aged 0-21 years who have been identified as being Medically Fragile (MDF) or having a Serious Emotional Disturbance (SED). CYES Nurse Evaluators conduct conflict-free evaluations of these children and youth to assess their needs for HCBS and develop person-centered plans of care. CYES Family Support Coordinators provide coordination and referral services and assist HCBS-eligible children or youth to apply for Medicaid.

Maximus conducts conflict-free assessments of adults who have intellectual and development disabilities on behalf of the New York State Office for People with Developmental Disabilities (OPWDD). Maximus Assessors use the Coordinated Assessment System (CAS) comprehensive assessment tool to identify the strengths, interests, and needs of these individuals, information which assists in their person-centered care planning.

Maximus conducts conflict-free assessments of children and youth aged 6-17 who have intellectual and development disabilities on behalf of the New York State Office for People with Developmental Disabilities (OPWDD). Maximus Assessors use the Child and Adolescent Needs and Strengths (CANS) comprehensive assessment tool to identify the strengths, interests, and needs of these children and youth, information which assists Care Coordination Organizations (CCO) in their person-centered care planning.

The New York Physician Profile (NYPP) program provides key information to health care consumers for every licensed and registered physician who practices in the state via a website and call center. NYPP maintains a database of health care provider profiles for more than 179,000 medical doctors and doctors of osteopathic medicine who are licensed in the state. These profiles include information about a doctor’s education, their practice, legal actions against them, and any professional activities. 

Agency:  North Dakota Department of Human Services

We manage the Qualified Individual assessment process for Qualified Residential Treatment Programs (QRTPs) as part of the FFPSA program. In this role, assessments are conducted to determine appropriate level of care for foster children.

Resources:

• Access tools and resources for North Dakota's FFPSA.

Agency:  North Dakota Department of Human Services (DHS), Medical Services Division

Since 2003, we have partnered with the DHS Medical Services Division to provide evaluation services for multiple programs, that currently include the following:

We partner with the DHS Medical Services Division to perform Level I, Level II and Level of Care (LOC) onsite evaluations for the Preadmission Screening and Resident Review (PASRR) program.

PASRR is performed on individuals who are applying to, or residing in, Medicaid-certified nursing homes. The main objective of this federally required assessment is to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities or developmental disabilities.

PASRR also works as a critical function to help match individuals with the care and services they need.

Resources:

• Access tools and resources for LOC and conducting PASRR assessments in North Dakota
• Learn more about PASRR 
• Help people understand what to expect of their PASRR assessment

We partner with the DHS Medical Services Division to conduct the initial screening for eligibility (Level of Care) and makes determinations regarding denials for this transition program.

This waiver covers children with high medical needs. Ascend reviews Level of Care screens and notification letters are sent to all parties.

The PACE program offers services for individuals living in the community. We review Level of Care screens and send notification letters to all parties.

Personal Care provides services associated with activities of daily living to individuals living in the community to help them maintain independence. We review screens to determine Level of Care needed and provide notification letters to all parties.

This program offers services to provide an alternative to institutional placement for individuals with defined needs. We perform Level of Care screens and sends notification letters to all parties.

The TBI waiver provides services to individuals who have TBI and who would otherwise be eligible to be admitted to a nursing facility. We perform annual Level of Care screens and send notification letters to all parties.

We conduct and manage Certificate of Need review and decisions for admissions of children under age 21 with mental health and substance abuse diagnoses seeking admission or continued stays in acute psychiatric and residential treatment centers. In addition, we conduct elective, emergency, and retrospective utilization reviews for persons under the age of 21.

Resources:

Access resources and tools for North Dakota's Under 21 Psychiatric Services 

We perform Medical Long Term Care Utilization Review (admission and continued stay reviews) for several other services provided by the State of North Dakota.

Agency: Ohio Department of Mental Health and Addiction Services (OhioMHAS)

Preadmission Screening and Residential Review (PASRR) functions as an essential method to help match individuals with the care and services they need. We partner with OhioMHAS to perform PASRR Level II - Serious Mental Illness (SMI) screens for people in, or considering, nursing home placement.

Resources: 

• Access tools and resources for conducting PASRR II - SMI assessments in Ohio
• Learn more about PASRR 
• Help people understand what to expect of their PASRR assessment
• Learn more about Intellectual and Developmental Disabilities (IDD) Assessments

Agency: Oregon Department of Human Services (DHS)

We partner with Oregon DHS to manage in-person eligibility reviews for people that may be experiencing mental illness along with possible physical needs for the Aging and People with Disabilities (APD) Program. Through the mental or emotional disorders (MED) Review process, we give DHS accurate review recommendations of an individual's primary need for services. Our assessment enables DHS to make informed program eligibility decisions based on a clear and accurate understanding of which programs may best address an individual's unique needs.

Resources:

• Access MED Review resources and tools for the State of Oregon 

Agency: State of South Dakota, Department of Social Services, Division of Medical Services

Maximus has been contracted to review all Pre-Admission Screening and Resident Review (PASRR) positive Level I screens for all individuals who are applying to or residing in Medicaid-certified nursing homes and complete Level II evaluations for individuals confirmed or suspected to have mental illness.

The primary goal of this federally mandated assessment is to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities or developmental disabilities. PASRR also works as a critical function to help match individuals with the care and services they need.

• Access tools and resources for conducting PASRR assessments in South Dakota
• Learn more about PASRR 
• Help people understand what to expect of their PASRR assessment

Agencies: Tennessee Department of Mental Health and Substance Abuse Services, the Department of Intellectual and Developmental Disabilities, and TennCare 

In partnership with these State of Tennessee agencies, we perform the following specialty assessment services:

• Level II on-site evaluations for the Preadmission Screening and Resident Review (PASRR) program (since 2005)
• Inventory for Client and Agency Planning (ICAP) (since 2004)
• Supports Intensity Scale (SIS^®) (since 2012)
• TennCare Choices Program Level of Care Denial Assessments

Agency: TennCare

Tennessee's Katie Beckett Waiver Program is for children under the age of 18 with disabilities or complete medical needs, who are not Medicaid eligible because of their parent's income or assets. This program will provide services and/or help pay for medical care that private insurance does not cover, and has two parts: Part A and Part B. TennCare has partnered with Maximus to complete face-to-face Part A assessments utilizing a Qualified Intellectual Disability Professional (QIDP),Qualified Mental Health Professional (QMHP), and/or Registered Nurse (RN). 

Katie Beckett provides Medicaid benefits to:

• Children under the age of 18
• Regardless of parent's income
• Covers in-home medical services where cost is less than or equal to treatment in an institutional setting

Resources:

• Go to the TennCare site to learn more about the Katie Beckett Waiver Program
• Contact the TN Katie Beckett Waiver Program - Part A Help Desk: 833.617.2777 | 7:30 am – 4:00 pm CST, M-F

We partner with the State of Tennessee to perform Preadmission Screening and Resident Review (PASRR) for individuals who are applying to, or residing in, Medicaid-certified nursing homes.

The primary goal of this federally mandated assessment is to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities or developmental disabilities. PASRR also works as a critical function to help match individuals with the care and services they need.

Resources: 

• Access tools and resources for conducting PASRR assessments in Tennessee
• Learn more about PASRR 
• Help people understand what to expect of their PASRR assessment

Supports Intensity Scale assessments are used to determine support needs for individuals with intellectual and/or developmental disabilities. 

Resources:

• Resources and tools for performing onsite uniform assessments using the SIS in Tennessee
• Learn more about SIS
• Help people understand what to expect of their SIS assessment

Agency:  Virginia Department of Behavioral Health and Developmental Services (DBHDS)

We partner with the Virginia DBHDS to perform Level II onsite evaluations for the Preadmission Screening and Resident Review (PASRR) program – and have done so since 2001. PASRR assessments are performed on individuals who are applying to, or residing in, Medicaid-certified nursing homes. The primary objective of this federally-mandated assessment is to determine whether the nursing home is the appropriate placement for individuals with mental illness, intellectual disabilities or developmental disabilities. PASRR also works as a critical function to help match individuals with the care and services they need.

Resources: 

• Access tools and resources for conducting PASRR Level II assessments in Virginia
• Learn more about PASRR 
• Help people understand what to expect of their PASRR assessment

We partner with Virginia DBHDS to perform onsite uniform waiver assessment services using the Supports Intensity Scale.  These assessments are used to determine support needs for individuals with intellectual and/or developmental disabilities. 

Resources:

• Resources and tools for performing onsite uniform assessments using the SIS in Virginia
• Learn more about SIS
• Help people understand what to expect of their SIS assessment

The Utilization Review Accreditation Commission (URAC) develops national standards to improve quality, protect consumers and improve health outcomes.

The Clinical Services Division of Maximus has been granted “Full” accreditation by URAC:

• Health Utilization Management - 7.4

Maximus has also been granted several other accreditations:

• Credentials Verification Organization (CVO) - 4.1
• Independent Review Organization: External Review - 5.1
• Workers' Compensation Utilization Management - 7.4

Learn more about URAC and each accreditation:

• URAC
• IRO
• CVO
• WCUM
• HUM

• Maximus U.S. Services
   
• Maximus Federal