Navigating the System of Behavioral Healthcare

1. 1 8/29/2012 Navigating the System of Behavioral Healthcare How to get mental health, developmental disability or substance abuse services

2. 8/29/2012 2 What is behavioral healthcare? Services designed to provide treatment for persons with a mental illness, a developmental disability or a substance abuse problem are often collectively referred to as behavioral healthcare services. These services should be delivered with dignity, respect your privacy and right to make choices, and help you take advantage of as many opportunities for personal growth and fulfillment as possible.

3. 8/29/2012 3 Who do I contact? If you think you or a family member needs mental health, developmental disabilities and/or substance abuse (MH/DD/SA) services, you should contact: A private company, known as a �service provider�. Service Providers offer a variety of services, but not all Service Providers offer all services. The Local Management Entity (LME), who will assist you in choosing a Service Provider that offers the specific treatment service to meet your particular needs.

4. 8/29/2012 4 What is an LME? The Local Management Entity (LME) is a local government agency that manages the services offered to children and adults with mental health, developmental disabilities, and substance abuse needs in our community. The four counties of Bladen, Columbus, Robeson and Scotland are served by one LME in our area.

5. 8/29/2012 5 Tell me about my local LME Southeastern Regional Mental Health, Developmental Disabilities and Substance Abuse Services (SRMH/DD/SAS) 450 Country Club Road Lumberton, NC 28360 ACCESS to CARE: 1-800-670-6871 Customer Services: 1-800-760-1238 TTY: 1-866-315-7368 Phone: 910-738-5261 Fax: 910-738-8230 E-mail: info@srmhc.org Webpage: www.srmhc.org

6. 8/29/2012 6 Southeastern Regional LME Southeastern Regional MH/DD/SAS is a community leader, working as a partner with other community agencies to build an array of services, supports and linkages that support adults, children and their families in achieving their life goals. Southeastern Regional MH/DD/SAS is working to develop home, neighborhood, and community based services and supports provided by service provider agencies that are responsive to the cultural, racial, and ethnic strength and differences of the citizens we serve. Southeastern Regional MH/DD/SAS is also committed to ensuring that the services offered to our citizens with mental health, developmental disability and substance abuse needs are of high quality and reflect the best standards of care.

7. 8/29/2012 7 How do I make contact? Service Provider 1) Visit their office 2) Call them on the phone LME 1) Visit our offices at 450 Country Club Rd Lumberton, NC Monday through Friday from 8:00 am to 5:00 pm 2) Call our toll free Access to Care number, 1-800-670-6871 24 hours per day, 7 days per week, 365 days per year. 3) Visit an Access Point and ask to make a call, or to have them help you make a call to the LME Access to Care number, 1-800-670-6871

8. 8/29/2012 8 What happens when I contact a service provider? The service provider will conduct a screening to determine if you have a behavioral healthcare need. Some Service Providers prefer to have the LME perform the screening, and will help you contact the LME Access to Care #, 1-800-670-6871.

9. 8/29/2012 9 What happens when I visit the LME office? Upon entry into the building at 450 Country Club Road in Lumberton, you should tell the receptionist that you need help with a behavioral healthcare issue. The receptionist will direct you to a private room where you can speak with a screening professional via telephone.* The screening professional will: ask for basic information about yourself and the problem you are experiencing** give you a choice of providers that offer the service that you need to meet your needs, based on the information that you supply*** make an appointment for you with the provider that you have chosen give you the date, time, and location of your appointment, along with contact information for the provider you have chosen After your appointment, an LME care coordinator will follow-up with you to make sure that you kept your appointment and are connected with a provider * A screening professional will see you face to face if the screener determines it is necessary ** Examples of information that you will need to give are your name, date of birth, address, telephone number, insurance information, symptoms you are experiencing. *** If your situation is one that requires immediate attention, the screening professional will connect you with the LME Mobile Crisis Team.

10. 8/29/2012 10 What happens when I call the LME 1-800-670-6871 Access to Care #? You will be connected with a screening professional, and will go through the same process as if you visited the LME office, (see previous page). The only difference is that you will go through the process from your home or from an Access Point, and will not have to drive to the LME office. If the screening professional determines that you need to be seen face to face, then you will be connected with the Mobile Crisis Team.

11. 8/29/2012 11 What is an Access Point? An Access Point is a location that allows you to use the telephone to call the LME toll free 1-800-670-6871 Access to Care number, offers assistance in making the call if requested, and provides a private space for you to make the call. Access Points display the toll free LME Access to Care # 1-800-670-6871.

12. 8/29/2012 12 Give me some examples of Access Points Some examples of Access Points are: Primary Care Physician Offices Department of Social Services Health Departments Vocational Rehabilitation Urgent Care Centers Hospitals Magistrate Offices Churches

13. 8/29/2012 13 Should I see my regular doctor or a psychiatrist? You should talk with your primary care physician about any symptoms that you have, including symptoms which may indicate that you have a behavioral healthcare need. Your primary care physician can then determine if he can treat your symptoms himself; consult with a psychiatrist; or refer you to see a psychiatrist face to face. Often, when treatment is successful and symptoms have improved, a patient that has been referred to a psychiatrist can be referred back to their primary care physician for regular care with occasional follow-up with the psychiatrist.

14. 8/29/2012 14 Will the LME choose a Service Provider for me? NO. The LME screening professional will use the information that the patient supplies to identify a group of service providers that are located in the patient�s area, and that provide the type of service needed to meet the patient�s needs. The patient must select the service provider they wish to deliver their services.

15. 8/29/2012 15 How should I select a Service Provider? When the LME screening professional presents you with a choice of providers, you should consider the following items when making your decision: if you have had any previous experience with a provider how quickly you can get an appointment with a provider the type of benefits that a provider accepts as payment if a provider can meet your cultural needs the reputation of the provider in the community

16. 8/29/2012 16 What happens at the appointment with my Service Provider? The LME screening professional forwards your screening information to your provider prior to your first appointment with your provider. At your first appointment with your provider some additional intake information is gathered, and an assessment is completed. After the assessment is completed, a person centered plan is completed. This may be scheduled for another time. When you, your provider, and significant others that you may want to assist, have completed your person centered plan, a request for authorization of services is made from your benefit plan. When authorization is received, services begin.

17. 8/29/2012 17 How do I know which services I NEED? The assessment completed by your provider determines the type of service(s) that are needed to meet your behavioral healthcare needs. The person centered plan that is developed determines how those services will be implemented.

18. 8/29/2012 18 What happens if I am having an emergency? If you are having a life threatening emergency you should call 911. If you are having a behavioral healthcare emergency you should call 1-800-670-6871. The screening professional will connect you with our Mobile Crisis Team. If you are having a behavioral healthcare emergency and are already being served by a behavioral healthcare provider, you should contact your behavioral healthcare provider. If your behavioral healthcare provider is not available, you should call 1-800-670-6871 in order to be connected with our Mobile Crisis Team.

19. 8/29/2012 19 What is Involuntary Commitment? When a patient is a danger to themselves or others, and whose current mental status makes them unable to seek voluntary treatment or physician recommended treatment, then a legal petition is filed to have the person receive treatment. Involuntary commitment is a last resort effort to protect the patient and others from harm. Voluntary community based services are designed to provide patients with the stability they need in order to avoid involuntary commitment.

20. 8/29/2012 20 What are In-Patient Services? In-patient services are delivered in a specialized hospital setting. These services are needed when the patient has an acute need that cannot be addressed with community services. The goal of in-patient hospitalization is to help a patient become stabilized so that their behavioral healthcare needs can be met with community based services. The goal of community based services is to help patients avoid in-patient hospitalization.

21. 8/29/2012 21 How do I pay for these services? An initial screening to determine your need for behavioral healthcare services is free. After it has been determined that you need behavioral healthcare services, the case manager who is assigned to you by the Service Provider agency you have chosen will discuss payment arrangements for the services with you. You will need to provide: Insurance information Proof of Income Some services are covered by insurance, and you will not be billed for those services, except for co-payments. If you do not have insurance, you will be billed for services on a sliding-fee scale based on your income.

22. 8/29/2012 22 What do I do if I have a question or complaint? The LME has a customer service office that you can call or visit when you have a question, complaint or want to provide some positive feedback. You can reach Customer Services at 1-800-760-1238 or visit our office at 450 Country Club Road, Lumberton, NC. We are open Monday through Friday from 8:30 am to 5:00 pm.

23. 8/29/2012 23 Customer Services Customer Services can provide you with information about: Your rights under North Carolina law How to file a complaint, grievance or appeal Eligibility for services Educational materials and classes Advocacy to help you get your needs and rights met

24. 8/29/2012 24 What are my rights? When you request services through the Service Providers associated with the LME, your rights are protected by North Carolina law. You have the right to: Be treated with respect and dignity Self-determination, privacy, humane care and freedom from physical punishment, abuse, neglect or exploitation An individualized, person-centered plan that you help to develop Be informed about medications Refuse treatment Be informed about what is expected of you in order for you to receive treatment services Know the cost of services that you receive Confidentiality

25. 8/29/2012 25 What are my confidentiality rights? State and federal laws require that information about you is shared only with your permission. However, these same laws require that information about you is shared with others under certain conditions. These include: A court order In an emergency If you are determined to be a danger to yourself or others As part of an investigation of child abuse You or your guardian will be asked to sign a �consent to treat� form, which includes general details of how your information is shared.

26. 8/29/2012 26 Are there other places that I can go to find help and support? Yes. There are a variety of support organizations available in our area. A listing of them can be found in the phone book or in the Resource Directory on the LME website at www.srmhc.org. Some local support groups include: AA (Alcoholics Anonymous) ARC (Association for Retarded Citizens) MHA (Mental Health Association) NAMI (National Alliance for the Mentally Ill)

27. 8/29/2012 27 Help is available The pain, loneliness and confusion don�t have to last. We�re here to help you receive affordable, convenient services to help you and your family deal with mental illness, developmental disability and substance abuse issues. If you have a behavioral healthcare need, or need help in determining if you have a behavioral healthcare need, please call the toll free # 1-800-670-6871 for a free, confidential screening.

28. 8/29/2012 28 Content Information This consumer manual was developed by Kathy S. Baker, Director of Planning and Collaboration; Southeastern Regional Mental Health, Developmental Disabilities and Substance Abuse Services. Content may not be altered or duplicated. In the event that procedures change, Southeastern Regional MH/DD/SAS will issue an updated booklet. For additional information, clarification, or additional copies, please contact: Kathy S. Baker Director of Planning and Collaboration Southeastern Regional MH/DD/SAS 450 Country Club Road Lumberton, NC 28360 Ph: 910-272-1208 Fax: 910-738-8230 kbaker@srmhc.org