(1) A child is eligible for medicaid reimbursed case management services for children at risk of abuse or neglect if the child is:

(a) 12 years or younger;

(b) at risk of abuse or neglect but is not at risk of immediate removal from the home; and

(c) not receiving case management services from any other case management providers.

(2) A child is at risk of abuse or neglect if:

(a) a provider of children at risk of abuse or neglect case management services determines the child to be at risk of abuse or neglect; and

(b) the child:

(i) has been referred to the child protective services program of the department based on the determination; or

(ii) even though not referred to the department, has high potential for abuse as indicated by the standardized partnership to strengthen families' risk referral (form PSF-01) and as verified by a partnership provider through the standardized assessment process utilizing the family life survey (form PSF-20) , the life experiences survey (form PSF-21) , and the basic family needs survey (PSF-23) . The department adopts and incorporates by reference the PSF forms referred to in this rule. A copy of the forms may be obtained from the Department of Public Health and Human Services, Child and Family Services Division, 1400 Broadway, P.O. Box 8005, Helena, MT 59620-8005.