Intensive Care Coordination (ICC) Program Referral Form

This referral form may be used for adults and youth in the Idaho Behavioral Health Plan (IBHP).

Intensive Care Coordination is available to all members with a mental health and/or substance use disorder diagnosis who meet certain criteria based on assessments. You can refer yourself to be assessed for Intensive Care Coordination. Your family member, a community member, or your provider can also refer you. If you do not meet the criteria, you may be eligible for Case Management, or you can get regular Care Coordination, as described above.