ANJI JORSTAD MENTAL HEALTH SUPERVISOR SNOHOMISH COUNTY HUMAN SERVICES OCTOBER 2015 Navigating Mental Health Services in Snohomish County

Presentation Overview Access and Eligibility MCO vs NSMHA Service providers Available services Crisis System Questions

Access and Eligibility Mental Health Benefit Private Insurance through Employer No Insurance Medicaid/Apple Health Private Insurance through HealthPlanFinder

Access and Eligibility CCall insurance company to get a list of covered providers DDetermine if you need a referral from your Primary Care Physician CCall and schedule an appointment GGo to Washington healthplanfinder = OOpen enrollment 11/1/15 – 1/31/16 SShop for coverage the fits your needs and budget SSee if you qualify for subsidized health coverage AA little less straightforward.... Private Insurance through employer No Insurance Private Insurance through Healthplanfinder Medicaid/ Apple Health

Access and Eligibility Public Mental Health – funded through Medicaid In WA, Medicaid = Apple Health Apple Health is comprised of 5 Managed Care Organizations Amerigroup Community Health Plan of WA - CHPW United Health Care Molina Coordinated Care

Access and Eligibility Most individuals with mental health issues can get their needs met through their Medicaid Managed Care plan Each plan outlines what individual and agency providers are covered All 5 Managed Care plans have a mental health benefit

Access and Eligibility What if your managed care plan cannot meet your needs because you have a severe and persistent mental illness? Then you may be eligible to receive mental health services through the Regional Support Network (RSN). Our RSN is the North Sound Mental Health Administration – NSMHA.

Access and Eligibility Need mental health services? Needs are too great for managed care provider (mental illness is severe and persistent)? Access services through NSMHA Call Access Line Answer a few questions about symptoms and insurance Intake appointment scheduled with provider agency Compass Health (youth and adults) Sea Mar (youth and adults) Sunrise Services (adults only) Catholic Community Services (youth only) Center for Human Services (youth only) Complete mental health assessment – eligibility determined and treatment plan started

Access and Eligibility Identify a desire for mental health services Contact your Medicaid managed care plan Do you have a severe and persistent mental illness? YES NO MCO provides list of covered providers, you call and schedule appointment Call the Access line Initial financial eligibility determined Schedule with selected agency Complete assessment Eligibility confirmed Begin Receiving Services!

Access to Care Standards must be met to receive services through the RSN/NSMHA Mental Illness Individual has a mental illness as determined by a Mental Health Professional (MHP) in a face-to-face intake/assessment. For children, assessment must be completed by or under the supervision of a Child Mental Health Specialist Diagnosis must be included in the list of Covered Diagnoses as defined by the WA State Division of Behavioral Health and Recovery Impairment Impairment and corresponding needs must be the result of mental illness. The individual must meet the Functional Criteria for SMI (Serious Mental Illness) or SED (Seriously Emotionally Disturbed). Intervention Intervention is deemed to be reasonably necessary to improve, stabilize, or prevent deterioration of functioning resulting from the presence of a mental illness. Individual is expected to benefit from the intervention. Additional considerations Individual need would not be more appropriately met by any other formal or informal system or support.

Continuum of Services – Children and Youth Developmental Disabilities Mental Illness  Mental health providers cannot provide services to individuals with developmental delays unless there are co-occurring issues.  Access to Care/Medical Necessity guidelines do not allow for treatment of developmental delays unless there is a mental illness and the mental illness is determined/assessed to be the primary issue driving the need for treatment.

Public Mental Health Service Providers Compass Health – – - Adults and Childrenwww.compasshealth.org Sea Mar Behavioral Health – Adultswww.seamar.org Sunrise Services – Adultswww.sunrisecommunityliving.com Catholic Community Services Childrenwww.ccsww.org Center for Human Services – – Infants and Childrenwww.chs-nw.org All publically-funded mental health agencies conduct a mental health assessment at intake and determine level of care. Level of care defines what services you are offered/eligible for. Each agency may offer additional services outside of what Medicaid will pay for – contact each agency directly or look on their website to learn about the full continuum of services offered. NSMHA – the North Sound Mental Health Administration – also has information about what services are available in each region. NSMHA – – You can also call 211 to get information about resources in your area.

Crisis Services  = Volunteers of America Care Crisis Line  Serves multiple purposes... Can help de-escalate crisis Can suggest resources to address crisis Can determine if dispatch criteria are met for Crisis Prevention and Intervention Team (CPIT) Can determine if dispatch criteria are met for Designated Mental Health Professional team (DMHP) Can facilitate referral to Sno. Co. Crisis Triage (18+)

Integrated Crisis Response System Crisis Chat Carecrisischat. org Volunteer-run Based on a national model Texting often preferable to youth and young adults Not 24/7, users are directed to line.org when crisis chat is not available line.org Care Crisis Clinician Available 24/7 Masters-level Training to de- escalate crisis Provide resources Help connect to other crisis response services CPIT Crisis Prevention and Intervention Team (formerly the Voluntary Team) Dispatched by Care Crisis Clinician 24/7, 2 hour dispatch time Community- based, provide peer support, crisis intervention Can provide and/or arrange ongoing services Crisis Triage (for 18+) Voluntary facility 16 beds and 4 23 hour sobering recliners Designed to support adults during a mental health crisis and connect to available resources Staffed by nurses, mental health professionals and peers 3-5 day stay, individually determined PIT (for youth) Parent Initiated Treatment Provider or crisis clinician can help determine if indicated If child is under age 18, parent can initiate inpatient hospitalization Can take to local ER or to inpatient facility – 5 inpatient facilities state-wide DMHP Designated Mental Health Professional The only avenue to involuntary hospitalization Narrow guidelines – danger to self, danger to others, gravely disabled, and all other less restrictive means have been exhausted

Continuum of services – Children and Youth Outpatient Services – Including individual and group modalities Psychiatric medication monitoring – ARNP or Psychiatrist prescribing and monitoring psychotropic medication Intensive Outpatient Services – Individual services at a higher intensity and frequency (coming soon for children and youth) WISe – Wraparound with Intensive Services – intensive services for the youth and family, includes parent support, family therapy, team approach, community and office based CLIP – Children’s Long-term Inpatient – voluntary, when all other less-restrictive options have been unsuccessful

Questions?

If you remember nothing else... Call the number on the back of your insurance card Call the Access Line: Call the Care Crisis Line: Don’t wait until there is a crisis to call the Care Crisis Line Look out for your community – call the Care Crisis Line if someone you know needs support

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