KIPBS positive behavior support and person-centered planning are community-based services for children who engage in socially inappropriate behaviors at such a frequency or intensity that they are at risk of out-of-home placement. People who may receive such services must meet the following eligibility criteria:

1. A Kan-Be-Healthy eligible child (age 0 to under 21) who is developmentally disabled, including mental
   retardation, as specified in K.S.A. 39-1801, et. seq., and/or has a verifiable diagnosis of autism.
2. A typically developing child (age 0 to under 21) who is Kan-Be-Healthy eligible and fits at least one of the criteria listed below.
   • The person's behavior significantly and consistently interferes with integration and participation in the community;
   • The person's behavior is dangerous to self and others;
   • The person's behavior provides a health risk;
   • The person's behavior is likely to become serious in the near future if not addressed;
   • The person's behavior is of great concern to the caregiver or is occurring at such a frequency or intensity that the caregiver's ability to effectively provide support is being compromised; or
   • The person's behavior results in significant damage to property.

Typically, the delivery of services will be limited to one billing cycle per recipient (i.e., the allowable hours of assessment, treatment, and person-centered planning that can be utilized during a one year billing cycle). There may be occasions when a case is determined to be so severe that a subsequent year of service is required. If this occurs, an exception may be considered. All exceptions must be prior authorized by submitting a new, updated Prior Authorization through KIPBS and receiving approval of the extension.

To determine if a child is Kan-Be-Healthy eligible, please call Electronic Data Systems (EDS) at 1-800-933-6593.

Prior Authorizations

KIPBS trained professionals will be able to bill Medicaid for positive behavior support (PBS) and person-centered planning (PCP) services. At this time, Community Developmental Disability Organizations (CDDO's) are the only provider type allowed for reimbursement of these services. If you are not affiliated with a CDDO, you will need to make an arrangement with your local CDDO to bill through their agency. Before billing can be submitted, KIPBS trained professionals will submit an application to the Prior Authorization Committee for approval.

The following conditions apply:

• Only persons who have successfully completed all the requirements of the KIPBS training system and are currently recognized by that system as approved for reimbursement may make application to the KIPBS prior authorization system.
• Child served must be present during hours that are being billed, (i.e., graphing and writing plans are not considered billable time).
• Only one provider can be billing for a service at one time, (i.e., Case Managers and KIPBS Facilitators cannot submit bills for the same time period during a PCP meeting, and KIPBS Facilitators cannot bill during school hours if the child is in special education and therefore receiving Medicaid support).

The KIPBS Prior Authorization application is available on the Internet at http://www.kipbs.org. This is a password protected site. (Contact KIPBS staff at kipbs@ku.edu if you need assistance accessing the site.) The password protected Prior Authorization section of this website will contain the following information:

• Information on the Prior Authorization process;
• Application forms; and
• A description of how applications will be reviewed and approved.

Click here for Frequently Asked Questions about becoming a KIPBS Facilitator and the Prior Authorization process.