Northwest Crisis Care System of Care Overview Policy

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Northwest Crisis Care System of Care Overview Policy and Procedures Illinois Department of Human

Northwest Crisis Care System of Care Overview Policy and Procedures Illinois Department of Human Services Division of Mental Health September 12, 2012: Dan Wasmer, MS Associate Director, Regional Services Updated 09 -11 -2012 1

Materials for today Ø Calendar Ø Presentation Slides Updated 09 -11 -2012 2

Materials for today Ø Calendar Ø Presentation Slides Updated 09 -11 -2012 2

Objectives of OVERVIEW Ø Ø Understand the flow of new Crisis Care System Understand

Objectives of OVERVIEW Ø Ø Understand the flow of new Crisis Care System Understand key policies Understand procedures Understand any interim policies and procedures Updated 09 -11 -2012 3

DHS/DMH Intent To enhance the existing Crisis Care system in Regions 2 W and

DHS/DMH Intent To enhance the existing Crisis Care system in Regions 2 W and 3 N by providing equivalent access to necessary levels of care that are: Community-based Ø Recovery oriented Ø Trauma informed Ø Outcome validated These services have historically been provided by Singer Mental Health Center. Ø Updated 09 -11 -2012 4

Services Ø Ø Ø Enhanced Crisis Response Community Hospital Inpatient Psychiatric Services (CHIPS) Mental

Services Ø Ø Ø Enhanced Crisis Response Community Hospital Inpatient Psychiatric Services (CHIPS) Mental Health Crisis Residential Acute Community Services (ACS) Transportation Updated 09 -11 -2012 5

Enhanced Crisis Response Ø Ø DHS/DMH expects that community providers in Region 2 W

Enhanced Crisis Response Ø Ø DHS/DMH expects that community providers in Region 2 W and 3 N will continue to respond to mental health crisis situations within their communities DHS/DMH is funding enhancements to this system to ensure timely access. Updated 09 -11 -2012 6

Eligibility Disposition Assessment (EDA) EVALUATORS Ø Minimum credential of Qualified Mental Health Professional (QMHP)

Eligibility Disposition Assessment (EDA) EVALUATORS Ø Minimum credential of Qualified Mental Health Professional (QMHP) Ø Available 24/7 Ø Respond within (1) hour of call Ø Determines financial and clinical eligibility Updated 09 -11 -2012 7

EDA EVALUATOR Ø Ø Conducts clinical evaluation and documents on DMH Uniform Screening and

EDA EVALUATOR Ø Ø Conducts clinical evaluation and documents on DMH Uniform Screening and Referral Form (USARF) Completes level of care assessment using the Level of Care Utilization System (LOCUS) Updated 09 -11 -2012 8

EDA EVALUATOR Determines if individual meets 2 clinical criteria for Region NCCS Ø Diagnosis

EDA EVALUATOR Determines if individual meets 2 clinical criteria for Region NCCS Ø Diagnosis of: Schizophrenia (295. xx) Schizo-affective D/O (295. 7) Shared Psychotic D/O (297. 3) Psychotic D/O NOS (298. 9) Major Depression (296. 2 x, 296. 3 x) Anorexia Nervosa (307. 1) Post Traumatic Stress D/O Schizophreniform D/O (295. 4) Delusional D/O (297. 1) Brief Psychotic D/O (298. 8) Cyclothymic D/O (301. 13) Obsessive-Compulsive D/O (300. 30) Bulimia Nervosa (307. 51) (309. 81) Bipolar Disorders (296. 0 x, 296. 4 x, 296. 5 x, 296. 6 x, 296. 7, 296. 80, 296. 89, 296. 90) Ø LOCUS Level of Care Recommendation of 4 or greater Updated 09 -11 -2012 9

EDA EVALUATOR Individual does NOT meet clinical criteria Ø Ø Inform referral source as

EDA EVALUATOR Individual does NOT meet clinical criteria Ø Ø Inform referral source as appropriate Provide any alternative treatment or service recommendation e. g. DMH Non-Medicaid benefit package Updated 09 -11 -2012 10

EDA EVALUATOR ØIndividual does meet clinical criteria ØEvaluator determines individual is a resident of

EDA EVALUATOR ØIndividual does meet clinical criteria ØEvaluator determines individual is a resident of Region 2 W/3 N No – refer to Elgin/Mc. Farland Yes – recommend level of care and service needs • CHIPS • Mental Health Crisis Residential • ACS • Transportation Updated 09 -11 -2012 11

EDA EVALUATOR Ø Ø Is the individual willing? Individual is NOT willing to engage?

EDA EVALUATOR Ø Ø Is the individual willing? Individual is NOT willing to engage? Does he/she meet criteria for involuntary hospitalization? Yes – proceed with process No – explain outcome of assessment, recommend level of care to individual, referral source and others of individual’s choice Updated 09 -11 -2012 12

EDA EVALUATOR Individual is willing to Engage Ø Inform referral source as appropriate of

EDA EVALUATOR Individual is willing to Engage Ø Inform referral source as appropriate of recommended level of care Ø If individual is in Emergency Department, assure that ED physician/staff concur Ø Evaluator calls the ACCESS line for • Authorization • Available services • Authorization number Updated 09 -11 -2012 13

Service Authorization Ø Illinois Mental Health Collaborative for Access and Choice • DMH’s Administrative

Service Authorization Ø Illinois Mental Health Collaborative for Access and Choice • DMH’s Administrative Service Organization (ASO) Toll free ACCESS Line (866) 359 -7953 Updated 09 -11 -2012 14

Service Authorization Ø Ø Clinical Care Managers (CCM) available 24/7 Evaluator provides information to

Service Authorization Ø Ø Clinical Care Managers (CCM) available 24/7 Evaluator provides information to ACCESS CCM • • • Ø Demographics Clinical presentation Recommended disposition CCM reviews for medical necessity Updated 09 -11 -2012 15

Service Authorization Ø When medical necessity is present for recommended level of care, the

Service Authorization Ø When medical necessity is present for recommended level of care, the CCM: Provides authorization number • Provides location and contact information for service provider • Updated 09 -11 -2012 16

EDA EVALUATOR Ø Evaluator • • • Contacts service provider to make referral. Makes

EDA EVALUATOR Ø Evaluator • • • Contacts service provider to make referral. Makes needed transportation arrangements using authorization number. Ensures required documentation (USARF, LOCUS, disposition and recommendations) is complete; distributes copies to ED (if involved) and accepting service provider (USARF, LOCUS, disposition and recommendations). Confirms linkage occurred within 24 hours. Registers individual in DHS/DMH consumer registration system. Updated 09 -11 -2012 17

Service Authorization Alternative Level of Care Ø If the CCM would propose a different

Service Authorization Alternative Level of Care Ø If the CCM would propose a different level of care based on medical necessity or capacity • • Evaluator discusses alternatives with the individual and ED physician/staff (if in an ED) If in agreement, authorization and referral process is initiated Updated 09 -11 -2012 18

Service Authorization If Not in agreement: Ø Collaborative CCM provides clinical presentation, treatment recommended

Service Authorization If Not in agreement: Ø Collaborative CCM provides clinical presentation, treatment recommended and capacity to Elgin/Mc. Farland Ø Elgin/Mc. Farland physician reviews information and discusses with ED physician (if involved). Ø Elgin/Mc. Farland considers option and determines most appropriate level of care and informs both CCM and ED physician (if involved). Ø CCM contacts Evaluator with determination and authorizes services as appropriate. Updated 09 -11 -2012 19

Disposition Options Community Hospital Inpatient Psychiatric Services (CHIPS) Ø Ø DMH funded, short-term inpatient

Disposition Options Community Hospital Inpatient Psychiatric Services (CHIPS) Ø Ø DMH funded, short-term inpatient treatment at community hospital. Serve those experiencing psychiatric crises and exhibiting acute behaviors or symptoms requiring inpatient setting. Updated 09 -11 -2012 20

Hospitals with CHIPS Contracts Swedish American Hospital, Rockford Memorial Hospital, Rockford OSF St. Elizabeth’s,

Hospitals with CHIPS Contracts Swedish American Hospital, Rockford Memorial Hospital, Rockford OSF St. Elizabeth’s, Ottawa Trinity Medical Center, Moline Provena Mercy Center, Aurora Updated 09 -11 -2012 21

Mental Health Crisis Residential Ø DMH funded, short-term 24/7 continuous supervision and treatment in

Mental Health Crisis Residential Ø DMH funded, short-term 24/7 continuous supervision and treatment in a provider controlled facility. • Rosecrance is the current provider. Updated 09 -11 -2012 22

Acute Community Service (ACS) Ø Ø Any services and supports needed by the individual

Acute Community Service (ACS) Ø Ø Any services and supports needed by the individual to continue stabilization from crisis. Grant funding allows the provider ultimate flexibility in determining type, amount, frequency, etc. , including medication Services must be initiated within 24 hours of the EDA Services must be initiated within 48 hours of discharge CHIPS, crisis residential, or SOH. Updated 09 -11 -2012 23

Acute Community Service (ACS) Ø Ø Ø Individual eligible for services up to 12

Acute Community Service (ACS) Ø Ø Ø Individual eligible for services up to 12 months of initial assessment Provider agrees to serve all referred/enrolled individuals Provider required to assist individual with application for medical assistance Provider required to register each individual through DHS/DMH information system Individuals will be referred to provider in their geographic proximity but will have choice if requested Updated 09 -11 -2012 24

Elgin and Mc. Farland Mental Health Centers Ø Will serve as safety net when

Elgin and Mc. Farland Mental Health Centers Ø Will serve as safety net when other services are not appropriate or available. Updated 09 -11 -2012 25

Elgin/Mc. Farland Mental Health Centers Ø When an individual presents with the following, Elgin/Mc.

Elgin/Mc. Farland Mental Health Centers Ø When an individual presents with the following, Elgin/Mc. Farland may be consulted for consideration of DMH admission. History indicating need for extended inpatient treatment • Presents challenges in discharge from inpatient setting, such as experiencing homelessness. • Updated 09 -11 -2012 26

Transportation Ø Ø DMH will purchase transportation services between site of EDA, CHIPS hospitals,

Transportation Ø Ø DMH will purchase transportation services between site of EDA, CHIPS hospitals, and MH Crisis Residential Individual must meet all eligibility criteria The Authorization number received from the Collaborative will serve as authorization for transportation Transportation provider must respond within 90 minutes of request Updated 09 -11 -2012 27

Phone Contacts Complaint Resolution/Help Line n 312 -814 -0930 Mc. Farland Mental Health Center

Phone Contacts Complaint Resolution/Help Line n 312 -814 -0930 Mc. Farland Mental Health Center n 217 -786 -6857 Elgin Mental Health Center n 847 -6239 n Alternate Phone: 847 -742 -1040 – have operator connect you to the Admissions staff person. n Questions can also be sent to: n Dhs. R 2 ccs@illinois. gov Updated 09 -11 -2012 28

Northwest Crisis Care System of Care Overview Policies and Procedures Thank you!! v Questions?

Northwest Crisis Care System of Care Overview Policies and Procedures Thank you!! v Questions? ? v Updated 09 -11 -2012 29

Overview Overview Overview Overview Overview Overview Overview RockOverview Overview Overview Overview Overview Overview Overview Rock
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