What Tier Would I Be Placed In?

Certain people who receive Medicaid through Developmental Disability Services and/or Behavioral Health Services will be contacted about an Independent Assessment – only Tiers 2 and 3. Read the following situations to decide where you might fit:

Developmental Disability Service Tiers

Tier 1:
Individual receives DD services under the Medicaid State Plan (DDTCS, CHMS, therapy, etc.), but does not meet ICF/IID level of care eligibility

Tier 2:
Individual meets ICF/IID level of care eligibility, but does not currently require 24 hours/day of paid support and services to maintain his or her current placement

Tier 3:
Individual meets ICF/IID level of care eligibility and does require 24 hours/day of paid support and services to maintain his or her current placement


Behavioral Health Services Tiers

Tier 1: Counseling
Time-limited services provided by a qualified licensed practitioner in an outpatient setting to assess and treat mental health and/or substance abuse conditions

Tier 2: Rehabilitative
Home and community-based services with care coordination including a full array of professional and para- professional services for individuals with higher needs. Services provided by certified behavioral health agency staff members.

Tier 3: Residential
Services provided in residential setting for individuals with the highest need

2 thoughts on “What Tier Would I Be Placed In?

  1. Who initially determines whether or not to contact the parent for them to have their child assessed? Meaning, initially who determines the Tier level of the child that determines whether to even be assessed? Especially if it is mental/behavior? Is it the medical PCP or mental health provider?

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    1. DHS has a list of people they think should be included. They have claims data from precious years to help them decide. The assessment confirms which tier the person is in, and very few end up being tier 1 (not included). DHS uses the assessment as a tool to determine the tier based on how you answer the questions.

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