Protocol for Coordination of Care Between Health Choice Integrated Care (HCIC) and Adult Probation Departments (APD) Effective 01/01/2016

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1 Protocol for Coordination of Care Between Health Choice Integrated Care (HCIC) and Adult Probation Departments (APD) Effective 01/01/2016 Health Choice Integrated Care (HCIC) and its Behavioral Health Homes, along with the Adult Probation Departments in Mohave, Coconino, Apache, Yavapai, Gila, and Navajo Counties agree to coordinate care in the areas of referral, intake and assessment, treatment planning, and crisis management for those enrolled in any treatment programs within the HCIC Network. HCIC, the Behavioral Health Homes, and Adult Probation believe that it is paramount to join efforts and form a partnership for the purpose of helping probationers who are being released from incarceration and/or are being supervised in the community access behavioral health services upon discharge. In order to ensure effective service delivery, both agencies agree to coordinate the roles and responsibilities outlined below. *Links for this protocol can be located on the HCIC website ( or in Provider Policy 4.4 Coordination of Care with Other Government Entities HCIC is the Regional Behavioral Health Authority for Coconino, Navajo, Yavapai, Apache, Gila and Mohave counties. Funds for services are provided through a contract with the Arizona Department of Health Services/Division Of Behavioral Health Services and AHCCCS". 1

2 Crisis Assessments Crisis Triage through HCIC s Behavioral Health Homes can be accessed during business hours and after hours, 24 hours a day, seven days a week. HCIC maintains a toll free telephone number [ ] for this purpose. Behavioral Health Homes (BHH) provide both telephone and face-toface Crisis Triage during business hours. Crisis Response Network staff provide telephone Crisis Triage after business hours and determine whether the person s needs are either Immediate, Urgent or Low/Routine. Immediate Need: Requires crisis assessment within less than two hours from identification of need or as quickly as possible when a response within 2 hours is geographically impractical. Urgent Need: Requires crisis assessment within less than 24 hours. Routine Need: Requires routine assessment within 7 days. Crisis Response Network is not required to contact staff at Behavioral Health Homes regarding members with Low/Routine acuity whose immediate needs have been handled during the Telephone Crisis Triage; however reports are forwarded to the Responsible Agencies by the next morning. All persons with Immediate or Urgent acuity are referred immediately by Crisis Response Network to on-call staff at the Responsible Agencies for Crisis Services. The on-call crisis evaluator will provide a mobile crisis assessment if there is an immediate or urgent need. BHH staff will arrange for hospitalization (when required) as well as transportation to the identified facility. The Behavioral Health Home will provide the date and time of the intake appointment to the Probation Officer. The BHH is expected to offer an intake appointment within 7 days of the request being made. For Persons in Crisis: See HCIC responsibilities for Crisis Triage Services, which are available 24 hours a day, 7 days a week by calling the local Responsible Agency or the HCIC Crisis Line [ ]. If the Probation Officer is making a referral for an individual experiencing a psychotic episode or is in crisis, be sure to request Crisis Triage services for immediate response. 2

3 Referral and Service Delivery HCIC s Behavioral Health Homes (BHHs) offer the comprehensive array of covered behavioral health services detailed in the Arizona Department of Health Services/ Division of Behavioral Health Services Covered Services Guide. Services-Matrix.pdf Upon receipt of the referral from the Adult Probation, BHH will offer an initial assessment to the member within 7 days of the referral. HCIC monitors providers to ensure compliance with PM 3.2: Appointment Standards and Timelines of Service. The BHH shall review Adult Probation documentation when considering treatment options for members. *The majority of HCIC s BHH are able to provide Same Day Intakes, granted the probationer arrives earlier in the day. If an intake is not possible for that day, the probationer will be asked to return by a specified time the following day. The BHH will notify Adult Probation if there is a change of status in any of the following as soon as able: Discharge Completion Change of groups Change of service / treatment plan Change of level of care Missed appointments Unplanned discharge from a Behavioral Health Acute Hospital Information that could be associated with any acute risk factors or community safety will be communicated to APD immediately. *The clinician will keep confidential the probationer s change in status until there is agreement with the assigned probation officer regarding the therapeutic value of the information. Adult Probation will communicate and collaborate with the BHHs to increase the probationer s participation in treatment services and attend Adult Recovery Team meetings as requested by the BHH. If it is determined that a probationer has an issue of substance abuse or mental heath, the probation officer will make a referral to the Responsible Agency (if there are multiple providers, probationer will choose) along with the following, as applicable: Terms of Probation Pre-sentence Report Offender Screening Tool or Risk Level (when completed and as requested) Case Plan (when completed) Release of Information Adult Probation will have probation officers available for consultation for Responsible Agencies. Adult Probation will notify the Responsible Agency if there is a change of status in any of the following as soon as able: A warrant has been issued Petition to revoke Probationer has absconded Probationer has been arrested/jailed Probationer has transferred out of the current service area Probationer has failed drug screens 3

4 Adult Recovery Teams (ART) The goals of an Adult Team are to enhance the member's engagement in services; improve the member's satisfaction and treatment outcomes; and to adhere to Arizona's Principles for persons who have a serious mental illness (SMI). If the member is hesitant about including Adult Probation during the ART process, the Behavioral Health Home will discuss with the member the advantages of having the complete team present for coordination of care and will attempt to mediate any concerns with Adult Probation s participation. The BHH will work with the member within a Trauma Informed Care approach. Attendance at ART meetings is guided by the probationer, though all ART members should be made aware of any updates resulting from the meetings. If the probationer refuses inclusion of Adult Probation at the ART, Probation may consider including the BHH during a probation-lead staffing to attend to enhance coordination of care. Mechanisms for Information Sharing Responsible Agencies and Adult Probation are committed to discussing the importance of coordination of care with the member/probationer. The BHH will maintain a current roster of offender referrals, level of care / treatment placements and case status. Upon request and in a timely manner, the Responsible Agency will provide Adult Probation with clinical documentation that has been authorized for release by the member. Adult Probation shall ensure that all necessary informed consents are obtained to allow for coordination of care pursuant to federal confidentiality of substance abuse treatment patient information (42CFR Part 2). *The member must agree to and sign a release of information for the RA to discuss any substance abuse issues with APD (per DBHS PM 4.1: Disclosure of Behavioral Health Information and 42CFR Part 2 requirements). 4

5 Problem Solving and Specialty Courts HCIC, the Behavioral Health Homes, and Adult Probation are committed to supporting the member s success in treatment, recovery, and adjudication through the process of the Problem Solving and Specialty Courts throughout our regions. Apache County: Drug Court Coconino County: Drug Court; Mental Health Court Gila County: Drug Court Mohave County: Drug Court Navajo County: Drug Court Yavapai County: Drug Court; Mental Health Court Behavioral Health Homes (BHHs) who have members involved with the county s Specialty Court will assign a regular representative to attend court hearings as well as the staffings that occur prior to court. BHHs will provide written and or verbal updates as requested by the Court and Adult Probation regarding members involved with Specialty Court. Adult Probation will ensure that the BHHs representatives have current lists of youth involved with the Specialty Court. Joint Training Joint training needs are discussed and decided on in a collaborative manner. Ideas for trainings are obtained from management staff at HCIC, the Behavioral Health Homes, and Adult Probation. Ideas can also come from line staff input during joint meetings, and HCIC s Adult and Children s Services Meetings. HCIC s Court Services Coordinator will schedule trainings as needed or requested by the Behavioral Health Homes and Adult Probation Departments. HCIC providers receive trainings relevant to substance abuse issues. Adult Probation is welcome to attend these trainings. Training on this Protocol is mandatory for all adult behavioral health employees who provide services for probationers. Appropriate APD employees should receive training within six months of employment and updates should be reviewed annually. 5

6 Information Sharing Member Privacy HCIC, Responsible Agencies and Adult Probation are committed to adhering to compliance with all HIPAA and 42 CFR Part 2 Requirements. Responsible Agencies will send encrypted s to APD when discussing specific client information. Secure faxes may be sent to HCIC at Process Improvement HCIC, Behavioral Health Homes, Arizona Office of the Courts, County Adult Probation Departments and AZ Dept. of Corrections have agreed to mutually plan for and attend joint meetings. All parties agree to use this opportunity to discuss systems related issues and jointly needed program development. Behavioral Health Homes and their county s Adult Probation Departments will meet at a minimum of twice each year. HCIC s Criminal Justice Liaison, along with AOC and ADC, will attend meetings at least annually and will coordinate as requested. HCIC s Criminal Justice Liaison will be called upon to coordinate and facilitate joint meetings at any time if any party desires for this assistance. Agenda items could include: Joint training needs What s working what s not working Reporting Community resources/ initiatives Mechanisms for Resolving Member/Consumer Complaints and System Barriers All persons involved with HCIC and/or Adult Probation have access to a complaint process for expression of dissatisfaction with any aspect of their care. Complaints about behavioral health or adult probation services should always be encouraged to be resolved at the lowest possible level, yet it is equally important that persons understand that a formal complaint process is also available when needed. Attempts to resolve issues at the local level should occur through the ART process but may also include contacting the Responsible Agency s Adult Services Manager or Director. Consultation is available at the regional level by HCIC and Adult Probation as needed. Adult Probation s Treatment Supervisors are the point of contact for directing member related complaints. Complaints pertaining to member specific situations can be reported to HCIC by utilizing their toll free telephone number: To submit a written complaint, mail the complaint to HCIC Member Services at 1300 S. Yale Street, Flagstaff, AZ System-level issues may also be reported to either the HCIC Adult Recovery Services Department or to Adult Probation Department for review at local or regional collaborative meetings. If issues cannot be resolved at these levels, see the DBHS Provider Policy Manual Section 5 for more information regarding grievance and appeal rights. Reports called Complaint Resolutions may additionally be reported to the Division of Behavioral Health Services. 6

7 Apache County Little Colorado Behavioral Health Centers (LCBHC) serves Apache County. LCBHC will updates to Probation Officers, as requested regarding treatment progress of probationer. Adult Probation to send a roster to case managers, clinical director and deputy clinical directors every 6 months. LCBHC will provide an intake for a probationer within seven days of receiving a referral. The case manager will contact the probation officer after the intake to confirm completion and request any further information. Adult Probation will include their substance abuse screening at time of referral, or as soon as it is competed. Drug Court meets weekly. Probation and LCBHC will continue to discuss needs and supports for ongoing programming during Court staffings. Coconino County Child & Family Support Services (CFSS), Southwest Behavioral Health Services (SBHS) and The Guidance Center (TGC) serve Coconino County. Behavioral Health Homes (BHHs) to incorporate Probation Report Adult Probation will send referral packets to BHHs on all referred template into monthly data collection and to to: probationers, regardless if they are already enrolled with HCIC agencies. apdtx@coconino.az.gov This will enable the BHHs to provide a means of tracking members who require monthly reporting to Adult Probation. APD will assist high needs probationers with same day intake or calling BHHs ahead of time to ensure intake ability. APD to call TGC and request AHCCCS eligibility specialist if needed. BHHs and Adult Probation will meet quarterly to discuss access to reporting, communication, and programming. 7

8 Gila County Community Bridges (CBI), Horizons Health & Wellness (HHWAZ), Southeast AZ Behavioral Health Services (SEABHS), and Southwest Behavioral Health & Services (SBH) serve Gila County Behavioral Health Homes (BHHs) will fax a confirmation of referral receipt and scheduled appointment time to APD. BHH will invite APD to an Adult Recovery Team meeting as soon as able. BHHs will fax or hand deliver monthly progress reports to APD. BHHs and APD will meet at least bi-annually. APD will fax referral packet to BHH. APD will try and attend initial Adult Recovery Team meeting. APD will verify Release of Information is on file for probationers for whom they are not receiving progress reports. Mohave County Mohave Mental Health Clinic (MMHC) and Southwest Behavioral & Health Services (SBH) serve Mohave County. Behavioral Health Homes (BHHs) will treatment/service plan to Adult Probation when completed and upon request. Adult Probation will referral packet, to include Release of Information, Offender Screening Tool, Pre-Sentence Report, and Substance Abuse Screening Tool to SBH s Program Director and to MMHC s Clinical Records Dept. (mmhc-roi-kingman@mmhc-inc.org) Case Plans and Conditions of Probation will be sent after the initial intake. BHHs will reports to Probation s Services Assistant to include Adult Probation will probation/member list to SBHS s Program updates on initial intakes. Directors and MMHC s Clinical Directors monthly by the 5 th of the month. On-going regular staffing times will be coordinated within the three regions of Mohave County. Navajo County Community Counseling Center (CCC) and Community Bridges Inc. (CBI) serve Navajo County CCC s clinicians complete monthly reports on template and directly to Probation Officer. Adult Probation will ensure CCC has updated lists of probationers. Drug Court Liaisons and Adult Probation meet quarterly with Drug Court Coordinator. CCC and Adult Probation meet quarterly to discuss high needs cases and programmatic needs. 8

9 Yavapai County Southwest Behavioral & Health Services (SBH), Spectrum Health Care, and West Yavapai Guidance Clinic (WYGC) provide services in Yavapai County. Behavioral Health Homes (BHHs) will fax back Client Advisory Reports after receiving blank requests from Adult Probation. BHHs and Adult Probation will meet jointly at least bi-annually. Adult Probation will fax/ Client Advisory Reports with probationer s name included as a request for member s treatment update. Adult Probation Department Contacts Apache County St. Johns, Springerville, Sanders Coconino County Flagstaff, Page Gila County Globe, Mohave County Kingman, Lake Havasu City, Bullhead City Navajo County Holbrook, Show Low, Snowflake, Winslow Yavapai County Prescott, Cottonwood 9

10 HCIC Behavioral Health Homes Contacts- Adult Services Providers A more detailed contact list is available at HCIC s website: Child & Family Support Services (Flagstaff / Prescott Valley) Flagstaff, Prescott Valley, Kingman Community Bridges, Inc. (Winslow / Holbrook / Payson / Globe) Winslow, Holbrook, Payson, Globe Community Counseling Centers (Winslow / Holbrook / Show Low / Snowflake/Taylor) Winslow, Holbrook, Show Low, Snowflake/Taylor Encompass Health Services (Page / Fredonia / Littlefield) Page, Fredonia, Littlefield Horizon Health & Wellness (Globe) Little Colorado Behavioral Health Centers (St. Johns / Springerville) St Johns, Springerville Mohave Mental Health Clinic (Kingman / Bullhead City / Lake Havasu) Kingman, (BHC), (LHC) Spectrum Health Care(Cottonwood / Camp Verde / Sedona) Cottonwood, Camp Verde Southeast Arizona Behavioral Health Services (Globe) (928) Southwest Behavioral Health Services (Bullhead City / Kingman / Lake Havasu City / Payson) Bullhead City, Kingman, Lake Havasu City, Payson The Guidance Center (Flagstaff / Williams) Flagstaff, Williams West Yavapai Guidance Clinic (Prescott / Prescott Valley / Chino Valley) Prescott, Prescott Valley, Chino Valley Health Choice Integrated Care