Eligibility

Appendix C – Priority Population – Adults SEVERELY MENTALLY ILL PRIORITY POPULATION DEFINITION - ADULTS (SMI) Revised 9/1/03, 3/10/14, 7/8/14, 8/26/20, 1/12/21 Reviewed 05/10/07, 1/25/10 

INCLUDED DIAGNOSES ICD-10 diagnosis codes: 

• F20.0 Paranoid Schizophrenia 
• F20.1 Disorganized Schizophrenia 
• F20.2 Catatonic Schizophrenia 
• F20.3 Undifferentiated schizophrenia 
• F20.5 Residual schizophrenia 
• F20.81 Schizophreniform Disorder 
• F20.89 Other schizophrenia 
• F20.9 Schizophrenia, unspecified 
• F22 Delusional Disorders 
• F25.0 Schizoaffective Disorder, Bipolar Type 
• F25.1 Schizoaffective Disorder, Depressive Type 
• F25.8 Other Schizoaffective Disorders 
• F25.9 Schizoaffective Disorder, unspecified 
• F28 Other Specified Schizophrenia Spectrum and Other Psychotic Disorder 
• F29 Unspecified Schizophrenia Spectrum and Other Psychotic Disorder 
• F31.0 Bipolar I Disorder, Current or Most Recent Episode Hypomanic 
• F31.13 Bipolar I Disorder, Current or Most Recent Episode Manic, Severe 
• F31.2 Bipolar I Disorder, Current or Most Recent Episode Manic, With Psychotic Features 
• F31.4 Bipolar I Disorder, Current or Most Recent Episode Depressed, Severe 
• F31.5 Bipolar I Disorder, Most Recent Episode Depressed, With Psychotic Features 
• F31.63 Bipolar I Disorder, Mixed, Severe, Without Psychotic Features 
• F31.64 Bipolar I Disorder, Mixed, Severe With Psychotic Features 
• F31.81 Bipolar II Disorder 
• F31.9 Bipolar I Disorder, Unspecified 
• F33.2 Major Depressive Disorder, Recurrent Episode, Severe 
• F33.3 Major Depressive Disorder, Recurrent Episode, With Psychotic Features 
• F60.3 Borderline Personality Disorder 

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.