AHCCCS Changes in SED Determinations

Date: 05/12/23

Arizona Complete Health-Complete Care (AzCH-CCP) was recently informed of changes AHCCCS is making to the SED determination process for children, effective October 1, 2023.

In January 2023, AHCCCS posted an announcement to their website:

“AHCCCS has awarded a contract to Solari, Inc. to maintain and improve the standardized processes used to determine eligibility for Arizonans who may have a Serious Mental Illness (SMI), and to standardize the Serious Emotional Disturbance (SED) determination process, in order to ensure that individuals with these designations are promptly identified and enrolled. The added SED eligibility determination process will standardize criteria for making these determinations which, until this point, has largely been the responsibility of clinicians. SED-designated children are a population with special health care needs who can receive services (in addition to Medicaid funded services) through the federal Mental Health Block Grant. Moving the determination process to a single vendor aligns with federal expectations and will help to ensure Arizona’s ability to support the needs of this population.”

We encourage all of our behavioral health provider partners to review the announcement, with particular attention to the SED FAQ (PDF).

AzCH-CCP will work closely with Solari, AHCCCS, and providers to share as much information as possible about implementation, timelines, and expectations.