Submitting the IMPACT Plus Application

It is best to have the IMPACT Plus Eligibility Application completed by a therapist or a Case Manager from an approved subcontractor agency (visit the Provider Directory link in the Related Links box) and signed by a behavioral health professional. The case manager will forward it to SHPS in Louisville for approval.

If instead you choose to forward your application to SHPS yourself, please mail or fax the IMPACT Plus Application to SHPS for approval, using the information below.

Address:
SHPS
Attn: IMPACT Plus Program
9200 Shelbyville Road, Suite 800
Louisville, KY 40222

Phone: (800) 292-2392 (Option 6)
Fax: (800) 807-7840 or (800) 807-8843

You will need mental health information from a therapist or hospital to complete the "IMPACT Plus Application for Eligibility" (see Case Management in Related Links), or have the parent or guardian select a Service Coordination agency located in the child's home region. (The home region is where the parent or guardian resides.) One of these agencies will help guide the parent or guardian through the eligibility process.