FAQ Directory: Long-Term Services and Supports Distinction for Health Plans

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6.15.2026 SMI and SED for PHM 2, Element B, Factor 4 Do organizations need to assess members with SMI, SED, or both?

For PHM 2, Element B, factor 4 the organization must assess the needs of members with serious mental illness (SMI) and assess the needs of members with serious emotional disturbance (SED). If a member has both conditions, separate assessments are not required under factor 4. The organization determines if the member is assessed as a member with SMI or SED.

Applicable standards: 
•    Health Plan Accreditation – PHM 2, Element B
•    Behavioral Health Accreditation – PHM 2, Element B

This applies to the following Programs and Years:
HP 2026|BHA 2026