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Intensive Behavioral Supportive Supervision (IBSS) is available under In Lieu of Services (ILOS). This voluntary service is administered by managed care organizations (MCO) and available to all Apple Health (Medicaid) clients who meet the clinical criteria and are enrolled in Apple Health managed care.
Who qualifies for IBSS services?
Apple Health clients may qualify for IBSS services if they meet all of the following criteria:
- Are an adult 18 years and older in a community residential setting.
- Are enrolled in an Apple Health MCO.
- Are at high risk of institutionalization and hospitalization due to complex behaviors.
- Require 10 or more hours of direct staffing supervision to prevent harm to self or others.
What is changing?
Policy adjustments were made to ensure IBSS serves the intended target population and complies with federal regulations. Changes are effective January 1, 2026.
Minimum tier requirements
- Individuals must meet Tier 4 or higher criteria for initial IBSS authorization.
- Individuals meeting Tier 1-3 may be approved in later authorization periods as behaviors stabilize in the community residential setting.
Exhaustion of other service options
IBSS may be authorized only after other appropriate service options are exhausted. To be eligible for IBSS, an individual must have care needs met through IBSS that cannot be served by other existing Apple Health programs such as Community Behavioral Health Support services. Clients who may be eligible for other programs must have a determination by the other service prior to IBSS authorization.
Policy guide updates
To clarify the distinction between Health-related social needs (HRSN) and ILOS pathways, HCA separated the former combined HRSN/ILOS Policy Guide into two separate documents:
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ILOS Policy Guide covering IBSS.
- HRSN Policy Guide covering Medicaid Transformation 1115 waiver services such as Medical Respite.
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Read the IBSS fact sheet and ILOS Policy Guide for details about IBSS requirements and how providers can offer IBSS.
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