The DDD American Indian Health Plan will be called the DDD Tribal Health Program (THP) effective October 1, 2021. DDD is aware of confusion in the community between its DDD American Indian Health Plan (AIHP) and AHCCCS’ American Indian Health Program (AIHP).
- Both options use a fee-for-service structure.
- The DDD AIHP is only for DDD members who are AI/AN and ALTCS eligible.
- The AHCCCS AIHP does not require ALTCS eligibility.
- The confusion is due to the similar names and use of AIHP.
This name change will help reduce confusion. Benefits and covered services are not impacted by this name change.
American Indians/Alaska Natives (AI/AN) can choose to receive services through a DDD Health Plan or the DDD Tribal Health Program (THP). American Indian/Alaska Native members can also receive physical and behavioral health services from any Indian Health Service (IHS) provider or tribally owned/operated facility at any time without prior approval.
American Indian/Alaska Native members that choose the DDD THP have two options:
- American Indians/Alaska Natives can choose the DDD THP and receive their physical health services, behavioral health services and Children's Rehabilitative Services (if eligible) from any AHCCCS authorized fee for service provider statewide.
- American Indians/Alaska Natives can choose the DDD THP and receive their physical health services and Children's Rehabilitative Services (if eligible) from any AHCCCS authorized fee for service provider statewide and behavioral health services from a Tribal Regional Behavioral Health Authority (TRBHA).
American Indians/Alaska Natives that choose the DDD THP can receive behavioral health services from a Tribal Regional Behavioral Health Authority (TRBHA), if one is available in their area. To receive behavioral health services from a TRBHA, members should call the AHCCCS Enrollment Unit:
- From area codes (480), (602), and (623) call 602-417-7100
- From area codes (520) and (928) call 1-800-334-5283
Behavioral Health Residential Facility Medical Necessity Criteria
If a member has a diagnosed behavioral health condition that reflects the symptoms and behaviors necessary for a request for residential treatment, the behavioral health condition causing the significant functional and/or psychosocial impairment shall be evidenced in the assessment by the following:
- At least one area of significant risk of harm within the past three months as a result of:
- Suicidal/aggressive/self-harm/homicidal thoughts or behaviors without current plan or intent,
- Impulsivity with poor judgment/insight,
- Maladaptive physical or sexual behavior,
- Member’s inability to remain safe within his or herenvironment despite environmental supports (i.e. informal supports), or
- Medication side effects due to toxicity or contraindications, and
- At least one area of serious functional impairment as evidenced by:
- Inability to complete developmentally appropriate self-care or selfregulation due to member’s behavioral health condition(s);
- Neglect or disruption of ability to attend to majority of basic needs, such as personal safety, hygiene, nutrition or medical care;
- Frequent inpatient psychiatric admissions or legal involvement due to lack of insight or judgment associated with psychotic or affective/mood symptoms or major psychiatric disorders;
- Frequent withdrawal management services, which can include but are not limited to, detox facilities, MAT, and ambulatory detox;
- Inability to independently self-administer medically necessary psychotropic medications despite interventions such as education, regimen simplification, daily outpatient dispensing, and long-acting injectable medications; or
- Impairments persisting in the absence of situational stressors that delay recovery from the presenting problem.
- A need for 24-hour behavioral health care and supervision to develop adequate and effective coping skills that will allow the member to live safely in the community;
- Anticipated stabilization cannot be achieved in a less restrictivesetting;
- Evidence that appropriate treatment in a less restrictive environment has not been successful or is not available, therefore warranting a higher level of care; and
- Member agrees to participate in treatment. In the case of those who have a health care decision maker, including minors, the health care decision maker also agrees to, and participates as part of, the treatment team.
Members with Questions About THP Can Contact DDD THP:
DDD Tribal Relations