Mental Health State Headquarters: 1225 South Weller Street, Suite - PowerPoint PPT Presentation

Mental Health State Headquarters: 1225 South Weller Street, Suite 420 Advocacy for Seattle, WA 98144 (206) 322-2444 Youth in Offices in King, Pierce, Snohomish, Yakima and Spokane Counties questions@teamchild.org Washington www.teamchild.org May 20, 2016

TeamChild Our Vision: Our Mission: TeamChild believes that it is TeamChild upholds the the paramount duty of our rights of youth involved, or community to help youth at risk of involvement, in overcome the obstacles of the juvenile justice system poverty, juvenile justice to help them secure the involvement, disability, education, healthcare, neglect and abuse, racism housing and other support and discrimination, in order they need to achieve to achieve their true positive outcomes in their potential. lives.

Mental Health Advocacy Roadmap of Training • Introduction / Overview • Why Mental Health Matters • Public Healthcare • How to get Mental Health Treatment / Scope of Services • Rights in the Public Mental Health System • Issue Spotting • Q & A

Why Does Good Mental Health Matter for Youth? • Success in school / Dropout prevention / Employability • Can lessen conflict in home / Homelessness prevention • Social development / Healthy friendships • Youth and community safety • Helps some youth stay out of trouble and out of the criminal justice system

Connection to Juvenile Justice System • Over 60% of children who enter Juvenile Rehabilitation Administration (JRA) custody have mental health needs. (Rehabilitation Administration, Facts and Figures, available at https://www.dshs.wa.gov/ ra/juvenile-rehabilitation/facts-and-figures, last accessed May 11, 2016) • Similar statistics nationally: – Approximately 70% of youth who come into contact with the juvenile justice system warrant at least one mental health diagnosis. About 55% warranted two or more co-occurring mental health diagnoses. ( Robert Kinscherff, Ph.D., Esq., A Primer for Mental Health Practitioners Working With Youth Involved in the Juvenile Justice System, January 2012 (citing multiple studies))

Eligibility for Medical Coverage Apple Health for Kids • Umbrella program in WA for public healthcare programs for youth (Medicaid, CHIP) • Youth/ families can apply online at www.wahealthplanfinder.org or at local community service offices of DSHS. • Questions? Call 1-855-923-4633. Unaccompanied minors cannot apply online but can call this number to apply.

What is EPSDT? • EPSDT = Early and Periodic Screening, Diagnostic, and Treatment See 42 USC § 1396d(r)), 42 C.F.R., Part 441, Subpart B, & Chapter 182-534 WAC. • Birth – 21 year olds who are eligible for Medicaid or state medical coverage • Focus on prevention and early intervention; regular screening and assessment • Includes treatment and services not in the state plan if they are “medically necessary” – Federal language: “necessary health care . . . to correct or ameliorate defects and physical and mental illnesses and conditions” 42 USC § 1396d(r)(5)

What qualifies as medically necessary? A service or treatment is “medically necessary” if it is: • reasonably calculated to prevent, diagnose, correct, cure alleviate or prevent worsening of conditions in the client; • to treat conditions that endanger life, or cause suffering or pain, or result in an illness or infirmity, or threaten to cause or aggravate a handicap, or cause physical deformity or malfunction; and • there is no other equally effective, more conservative or substantially less costly course of treatment available. See WAC 182-500-0070; WAC 388-865-0150

Mental Health Delivery System WA’s public mental healthcare system is largely a managed care system with some fee for service benefits. Health Care Authority Department of Social and Health Services Division of Behavioral Health and Recovery Behavioral Health Organizations (BHOs) Behavioral Health Agencies or Fee for service Community Mental Health Agencies benefits Children’s Long-Term Inpatient Program (CLIP)

How does a child access mental health services? • Intake at community mental health agency • Private providers / therapists • Primary care doctor referral • Crisis care / short-term or long-term hospitalization – Residential placements through Medicaid – Involuntary commitment

Scope of Mental Health Services • Brief Intervention • Psychological Assessment • Crisis Services • Rehabilitation Case Management • Day Support • Residential Treatment • Family Treatment • Special Population • Freestanding Evaluation Evaluation and Treatment • Stabilization Services • Group Treatment • Therapeutic • High Intensity Treatment Psychoeducation • Individual Treatment Additionally • Medication Management • Anything medically and Monitoring necessary under EPSDT • Peer Support

Consumer Rights • Right to all necessary services to correct or ameliorate illnesses and conditions. See EPSDT. • Right to notice / due process – For terminations, suspensions, reductions of previously authorized services – For denials or limited authorization of requested services – Continued benefits. See Chapter 388-877A WAC and federal law. • Right to avoid delay. See 42 U.S.C. § 1396a(a)(8).

Consumer Rights (Continued) • Age of consent. See RCW 70.02.130; RCW 70.96a.230. • Right to privacy/ confidentiality. See HIPPA . • Other rights provided under state law: – Right to develop a treatment plan to meet individual needs – Right to choice of providers (including to change providers) – Right to a second opinion. See Chapter 388-877A WAC.

Advocate! Consumers can challenge a denial, termination, suspension, or reduction of mental health services. Consumers can also enforce other consumer rights. • Informal advocacy • Request a second opinion Note: Ombuds services are available to help consumers.

Advocate! (Continued) • File a grievance with the behavioral health agency or the Behavioral Health Organization (formerly Regional Support Network) • File an appeal with the Behavioral Health Organization (formerly Regional Support Network) • Request an administrative hearing (“fair hearing”). Must exhaust.

Issue Spotting • Eligibility issues/ Access to Care Standards • Waiting lists for treatment • Limited scope of services/ caps on services • Co-occurring developmental disabilities • Lack of psychiatric and psychological services

Issue Spotting (Continued) • Multiple providers • Access to all services for unaccompanied minors • Blaming others, shifting responsibility • Lack of notice of client rights • Engaging youth in treatment

Resources • TeamChild (statewide (206) 322-2444 headquarters) www.teamchild.org/wellnessproject • CLEAR (Coordinated Legal (888) 201-1014 (outside King Education Advice and Referral) County) or 211 (King Co.) • Disability Rights (800) 562-2702 Washington • Mental Health By county Ombudsman Services (360) 584-9622 • NAMI Washington

State Headquarters: 1225 South Weller Street, Suite 420 Seattle, WA 98144 Thank You (206) 322-2444 Offices in King, Pierce, Snohomish, Yakima and Spokane Counties questions@teamchild.org www.teamchild.org “Treat people as if they were what they should be, and you help them become what they are capable of becoming.” -Goethe