At-Risk Criteria

The impairment experienced by the member are to such a degree that they meet the criteria for being at risk of out of home placement as defined in the below section.


These services shall be provided in this level of care when the clinical needs of the individual put him at risk for out-of-home placement, as these terms are defined in this section:

  • When services that are far more intensive than outpatient clinic care are required to stabilize the individual in the family situation, or
  • When the individual’s residence as the setting for services is more likely to be successful than a clinic.


  • Have difficulty in establishing or maintaining normal interpersonal relationships to such a degree that they are at risk of hospitalization or out-of-home placement as defined in the definition section of this manual because of conflicts with family or community; and/or
  • Exhibit such inappropriate behavior that documented, repeated interventions by the mental health, social services, or judicial system are or have been necessary resulting in being at risk for out of home placement; and/or
  • Exhibit difficulty in cognitive ability such that they are unable to recognize personal danger or recognize significantly inappropriate social behavior resulting in being at risk for out of home placement.


At least one parent/legal guardian or responsible adult with whom the individual is living shall be willing to participate in the intensive in-home services with the goal of keeping the individual with the family. In the instance of this service, a responsible adult shall be an adult who lives in the same household with the child and is responsible for engaging in counseling and service-related activities to benefit the individual.