BHID Referral

Signature & Policy Requirements

If the applicant is unavailable to sign the electronic referral, please print out the physical signature form and have them sign the CTT Application for Services Signature Form. Upload the completed signature form in the attachments section of the online application. You can also email additional attachments to cttbhidadmissions@pmhcc.org if needed.

Print / Download Signature Form

* Notice: CTT Case Management Programs are voluntary. All referrals must be accompanied with a participant signature.

The Seven Steps to a Successful Referral:

Review Medical Necessity Criteria
Fill-out referral form for the CTT Program you feel is most appropriate for your participant
Upload all required paperwork at the end of the referral form
* If you are unable to upload the forms please email them to the program you are referring to:
‍B: cttBHIDadmission@pmhcc.org
CTT will review the referral and provide a conditional authorization
Submit a program discharge summary / letter to the program you are referring to
Complete closure in Webfocus
CTT will send out acceptance form and admission date

*** n.b CTT Case Management Programs are voluntary. All referrals must be accompanied with a participant signature. You may download the signature form here. The signature form is used in those instances where the participant was unable to sign the original referral.

Please review the eligibility requirements for the BHID Team.
‍
Successful admissions to the BHID team require a minimum age of 21 along with documentation or suspicion of a previous diagnosis of an Intellectual Disability.

Please access the online BHID Service Application here

Interested in referring someone living with serious mental illness and diagnosed with an intellectual disability to the BHID Team? Please review the Medical Necessity Criteria below prior to completing the application, as well as the BHID program description.

Ready to Submit a Referral?

CTT is now accepting referrals into the BHID Program.

Click here to apply online

Steps to a Successful Referral

Review Medical Necessity Criteria.

Fill out referral form for the CTT Program you feel is most appropriate for your participant.

Upload all required paperwork at the end of the referral form. (If unable to upload, email them to: cttBHIDadmissions@pmhcc.org).

CTT will review the referral and provide a conditional authorization.

Submit a program discharge summary / letter to the program you are referring to.

Complete closure in Webfocus.

CTT will send out acceptance forms with an admission date.

Eligibility & Medical Necessity Criteria

Participants referred to CTT BHID Team must meet the eligibility requirements which includes:

Age & Diagnosis: Adults 21 & over with co-occurring behavioral health and intellectual disability diagnoses with significant functional impairment that result in the inability to maintain a safe living situation.

ID Level Restriction: ID diagnosis must be Mild or Moderate ID ONLY.

Required Documentation: The individual has documentation of Mild or Moderate ID. Documentation such as but not limited to: school records indicating special education classes and level of functioning, specific IEP for the individual, psychological evaluation that includes testing scales and full-scale IQ score, individual ISP detailing ID services for the individual.

Housing & Survival Need: Significant difficulty meeting basic survival needs, residing in substandard housing, or imminent risk of becoming homeless.

Behavioral Health/Intellectual Disabilities

Signature & Policy Requirements

Ready to Submit a Referral?

Steps to a Successful Referral

Eligibility & Medical Necessity Criteria