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​Appendix C – Priority Population – Adults
SEVERELY MENTALLY ILL
PRIORITY POPULATION DEFINITION - ADULTS (SMI)
Revised 9/1/03, 3/10/14, 7/8/14 Reviewed 05/10/07, 1/25/10

INCLUDED DIAGNOSES (DSM-5 – including ICD-9 and ICD-10 diagnosis codes):

295.90/F20.9          Schizophrenia
295.40/F20.81        Schizophreniform Disorder
295.70/F25.0          Schizoaffective Disorder, Bipolar Type 
295.70/F25.1          Schizoaffective Disorder, Depressive Type
298.8/F28               Other Specified Schizophrenia Spectrum and Other Psychotic Disorder
298.9/F29               Unspecified Schizophrenia Spectrum and Other Psychotic Disorder
297.1/F22               Delusional Disorder
296.33/F33.2          Major Depressive Disorder, Recurrent Episode, Severe
296.34/F33.3          Major Depressive Disorder, Recurrent Episode, With Psychotic Features
296.43/F31.13        Bipolar I Disorder, Current or Most Recent Episode Manic, Severe
296.44/F31.2          Bipolar I Disorder, Current or Most Recent Episode Manic, With Psychotic Features
296.53/F31.4          Bipolar I Disorder, Current or Most Recent Episode Depressed, Severe
296.54/F31.5          Bipolar I Disorder, Most Recent Episode Depressed, With Psychotic Features
296.40/F31.0          Bipolar I Disorder, Current or Most Recent Episode Hypomanic
296.40/F31.9          Bipolar I Disorder, Current or Most Recent Episode Hypomanic, Unspecified
296.7/F31.9            Bipolar I Disorder, Current or Most Recent Episode Unspecified
296.80/F31.9          Unspecified Bipolar and Related Disorder
296.89/F31.81        Bipolar II Disorder
301.22/F21            Schizotypal Personality Disorder
301.83/F60.3          Borderline Personality Disorder

-and-

In order to be included in the PRIORITY POPULATION, individuals must meet the target diagnostic criteria and meet the following functional limitations:

Serious mental illness is characterized by impaired role functioning, on a continuing or

intermittent basis, for at least two years, including at least three of the following:

Inability to maintain independent employment,
Social behavior that results in interventions by the mental health system,
Inability, due to cognitive disorganization, to procure financial assistance to support living in the community,
Severe inability to establish or maintain a personal support system, or
Need for assistance with basic living skills.

The diagnostic criteria may be waived for the following two conditions:

1.An individual committed as not criminally responsible who is conditionally released from a Mental Hygiene Administration facility, according to the provisions of Health General Article, Title 12, Annotated Code of Maryland. Or

2.An individual in a Mental Hygiene Administration facility with a length of stay of more than 6 months who requires RRP services, but who does not have a target diagnosis. This excludes individuals eligible for Developmental Disabilities services.




Referrals
Referrals can be mailed, email or faxed to the address below:

Lower Shore Clinic, Inc.
505 East Main St. Salisbury, MD 21804 
ATTN: Centralized Referral 

referral@lowershoreclinic.org

Fax: 410 341-3397
Individuals referred to Go-Getters must have a diagnosis listed below. New referrals are reviewed every Friday morning.