Behavioral Health Benefits and Member Supports
Sunshine Health cares about the wellbeing and safety of our members. That’s why we offer behavioral health services and substance abuse treatment that supports coping, recovery, wellness management and independent living skills.
Urgent Behavioral Health Resources
Always Call 911 If Someone’s Safety is at Imminent Risk
Sunshine Health Behavioral Health Crisis Line
- Phone: 1-866-796-0530
- TTY: 1-800-955-8770
- Hours: 24/7 help 365 days a year
- Help: Learn how to help a friend
- Behavioral Health Crisis
988 Suicide & Crisis Lifeline
- Phone: 988
- Chat: 988lifeline.org
- Hours: 24/7 help 365 days a year
- Help: Trained counselors available
- Press 1 to reach the Veterans Crisis Line
CMS Health Plan Behavioral Health Crisis Line
- Phone: 1-866-799-5321
- TTY: 1-800-955-8770
- Hours: 24/7 help 365 days a year
- Help: Call if your child is in crisis
- CMS Behavioral Health Crisis
Learn More About Accessing These Resources
Community Connections Team
- Help Line: 1-866-775-2192
- Video Relay: 1-855-628-7552 (TTY: 711)
- Monday to Friday, 9 a.m. to 6 p.m. Eastern
- Community Connections
- Sunshine Health Connects
Sunshine Health Member Services
- Call: 1-866-796-0530 (TTY: 1-800-955-8770)
- Monday to Friday, 8 a.m. to 8 p.m. Eastern
- Sunshine Health Member Services
CMS Health Plan Member Services
- Call: 1-866-799-5321 (TTY: 1-800-955-8770)
- Monday to Friday, 8 a.m. to 8 p.m. Eastern
- CMS Health Plan Member Services
In Lieu of Services Program (ILOS)
Sunshine Health offers medically appropriate substitutes for Medicaid benefits.
| Benefit | In Lieu Of |
|---|---|
Crisis Stabilization Unit (CSU) | Inpatient Psychiatric Hospital |
Free Standing Psychiatric Hospital | Inpatient Psychiatric Hospital
|
Detoxification or Addiction Receiving Facility | Inpatient Detoxification Hospital Care |
Partial Hospitalization Services | Inpatient Psychiatric Hospital Care |
Mobile Crisis Assessment and Intervention | Emergency Behavioral Health Care |
Ambulatory Detoxification Services | Inpatient Detoxification Hospital Care |
Self-Help/Peer Services | Psychosocial Rehabilitation Services |
Drop-In Center Services | Clubhouse Services |
Infant Mental Health Pre & Post Testing Services | Psychological Testing |
Family Training & Counseling for Child Development | Therapeutic Behavioral Onsite Services |
Community-Based Wraparound Services | Therapeutic Group Care Services or Statewide Inpatient Psychiatric Program Services |
Short-Term Residential Treatment (SRT) | Inpatient Detoxification Hospital Care |
Multi-Systemic Therapy | Inpatient or Residential Treatment |
Substance Abuse & Mental Health Intensive Outpatient Program (IOP) | Inpatient Detoxification or Psychiatric Hospital Care |
Nursing Facility Services | Inpatient Hospital Services |
Standard Benefits
- Primary Care Services (unlimited)
- Family Therapy Services
- Group Therapy Services
- Individual Therapy Services
Expanded Benefits
- Biometric Equipment
- Art Therapy
- Acupuncture
- Chiropractic Services
- Equine Therapy
- Home Allowance
- Pet Therapy
Evidence Based Practices
Sunshine Health proudly supports the evidence-based practices below to support members' behavioral health. View a full list of EBP providers we support across the state.
- Brief Strategic Family Therapy (BSFT): An intensive clinical intervention for families with youth ages 6 to 17 who are exhibiting problem behaviors such as substance use, conduct problems and delinquency.
- Child Parent Psychotherapy®(CPP): An intensive clinical intervention to address infant/early childhood trauma with parents of young children to improve protective capacity by enhancing the parent-child relationship and attachment. Sunshine Health will cover CPP for members ages 0-3 who are receiving the service in the context of Early Childhood Court.
- Functional Family Therapy (FFT): A clinical intervention for families of youth at risk of involvement in juvenile justice, mental health or child welfare systems and their families. FFT is designed for 11- to 18-year-old youth and their families to address at-risk behavior and foster individual skill-building for both youth and family.
- Multisystemic Therapy (MST): An intensive intervention designed to assist youth ages 12-17 across various settings. Its primary objective is to foster pro-social behavior while reducing criminal activity, mental health issues, out-of-home placements and illicit substance use in adolescents.
- Parent-Child Interaction Therapy (PCIT): For children aged 2-7 and their parents or caregivers. PCIT assists parents in enhancing their behavior-management abilities to address externalizing behaviors in children, promote positive parenting practices and enhance the overall quality of the parent-child bond.
- Motivational Interviewing (MI): A therapeutic technique designed to elicit behavior change by helping explore and resolve ambivalence. MI should be paired with community-based substance use treatment (and/or treatment for co-occurring disorders).
- Healthy Families America (HFA): An infant and early childhood home visiting program that provides parent skill development to new and expectant families with children between the ages of 0-5. Eligibility for the service may vary by site.
- Homebuilders: An intensive family preservation program for Child Welfare providing in-home counseling and support services to families with children ages 0-18 at risk of being out of home placement or placed out of home and requiring intensive in-home assistance for reunification. This program is designed to avoid unnecessary placement of children and youth into the foster care system.
- Nurse Family Partnership (NFP): The Nurse Family Partnership (NFP) is an infant and early childhood home-visiting prevention program helping young, first-time mothers from early pregnancy until their child reaches the age of two. The main objectives of NFP are to enhance the health, relationships and economic well-being of both mothers and their children.
- Parents as Teachers (PAT): Infant and early childhood home-visiting program that provides parent education and support to new and expectant parents with the aim of promoting positive child development and preventing child maltreatment. PAT focuses on increasing parents' knowledge of early childhood development, improving parenting practices, facilitating early detection of developmental delays and health issues, preventing child abuse and neglect and enhancing school readiness and success.
Special Programs
- Happy: Offers 24/7 support for social isolation and loneliness.
- Long-Acting Injectable Antipsychotics (LAIA): Monthly injections for schizophrenia that can improve medication compliance, lower ED visits and stabilize members within the community. No prior authorization for members 18 years and older.
- Housing Assistance Pilot Program (PDF): For adult Medicaid members who are homeless or at risk of being homeless and who also have a behavioral health diagnosis or struggle with substance abuse. Provides housing for members and offers treatment.
- Region C: Pasco, Pinellas counties.
- Region E: Brevard, Orange, Osceola, Seminole counties.
Healthy Rewards
| Amount | Activity | Description |
|---|---|---|
| $50 | Substance Use Treatment for Pregnant Members Using Drugs | Complete five Medication Assisted Treatment visits before delivery; provide evidence of completed counseling and medication sessions. |
| $10 | Substance Use Health Coaching | Ages 12 years and up. Complete 3 coaching sessions with a Care Manager in 3 months; must enroll in Case Management and provide signed consent form. |
| $20 | Post Behavioral Health Admission Follow up Visit | Earn rewards for attending an outpatient follow up appointment with a behavioral health provider within 7 days after discharge from an inpatient facility. |
View the full list of Healthy Rewards.