Collaborative Protocol between Cenpatico Integrated Care and Cochise County Adult Probation 2014-2015

Collaborative Protocol between Cenpatico Integrated Care and Cochise County Adult Probation 2014-2015

Table of Contents Introduction... 1 Definitions... 1 Referral Process... 3 Voluntary Crisis Services in the Cochise County Jail... 3 Routine Referrals for Outpatient Treatment Title XIX... 4 Routine Referrals for Outpatient Treatment- Non Title 19... 4 Community Reentry Program... 4 Intake and Assessment... 4 Coordination of Care... 5 While Detained... 5 While Living in the Community... 5 The Cochise County Adult Drug Court... 6 Ongoing Collaboration... 7 Issue Resolution... 7 Signature Page... 8

Introduction Cenpatico of Arizona, LLC, and Cochise County Adult Probation Department agree to coordinate care in the areas of referral, intake and assessment, treatment planning, and crisis management. Both agencies agree that effective service delivery is initiated and maintained by forming a strong alliance as the foundation for coordinating the roles and responsibilities that are outlined in this document. Cenpatico and Adult Probation will coordinate the delivery of behavioral health services to persons who are served by both organizations as follows: provide mechanisms for resolving problems, develop standardized information sharing processes, address the resources that each contributes to the care and support of persons mutually served, and collaborate to develop joint training programs. These principles are consistent with the Arizona Department of Health Services/Department of Behavioral Health (ADHS/DBHS) Provider Manual-Cenpatico Edition, ADHS/DBHS Policy and Procedure Manual, and ADHS/DBHS Clinical Practice Protocols. Probation Officers connect Cenpatico-enrolled probationers with behavioral health treatment and services while providing opportunities for successful completion of probation through close supervision, timely case management, education, training, advocacy and collaboration with the mental health community. The Probation Officer has the responsibility of monitoring the probationer s compliance within the conditions of probation and addressing the probationer s social, emotional, and mental health needs. Collaboration between the probationer, probationer s family, Cenpatico-contracted providers, Cenpatico, and the Probation Department is important to ensure that all parties work together to assess the probationer s strengths and needs, monitor progress, and provide appropriate services. The Probation Officer will be consulted as part of the assessment and service planning process in order to ensure that the goals are consistent with court-ordered mandates. Definitions Adult Recovery Team (ART) - A group of individuals, that following the nine Guiding Principles for Recovery-Oriented Adult Behavioral Health Services and Systems work in collaboration and are actively involved; in a person's assessment, service planning and service delivery. At a minimum, the team consists of the person, his/her guardian (if applicable) and a qualified behavioral health representative. The team may also include members of the enrolled person's family, guardian, physical health, mental 1 P age

health or social service providers, representatives or other agencies serving the person, professionals representing various areas of expertise related to the person's needs, designated representatives or advocates or other persons identified by the enrolled person. The group, in a culturally and linguistically appropriate manner consistent with Federal CLAS standards, establishes and prioritizes service goals identifying the supports necessary to reach those goals Administrative Office of the Court (AOC) - Provides the necessary support for the supervision and administration of all State courts. The Adult Probation Services Division of the AOC oversees the effective statewide administration of adult probation programs and services in accordance with statutory and administrative guidelines. Crisis Mobile Team (CMT) - Mobile team providers in Cochise County include Community Bridges (CBI) and Community Intervention Associates (CIA). The CMT s cover the entire County but in general CIA covers Douglas and Bisbee, and CBI covers Benson, Wilcox and Sierra Vista (and the surrounding areas). Crisis Mobile Teams are accessed through the NurseWise crisis line (866-495-6735). They provide community-based crisis intervention and are available to any person in the County regardless of insurance or enrollment status Intake and Coordination of Care Agencies (ICC Agency) - Agencies contracted with Cenpatico that provide intake provider functions and requirements. ICC Agencies are required to perform the roles of case manager, including; assessments, service planning, clinical oversight of all services, service tracking, data reporting, engagement activities, psychiatric services and ensure adequate service availability to all enrolled participants as outlined in the ADHS/DBHS Provider Manual, Cenpatico Edition and the ADHS/DBHS Covered Behavioral Health Services Guide. Office of Behavioral Health Licensing (OBHL) outpatient license required. * Local intake providers in Cochise County are: Arizona Children s Association (AZCA), ACTS, CIA, Corazon, Pinal Hispanic Council (PHC) and Southeastern Arizona Behavioral Health Services SEABHS. ICC Agencies are further divided into High Needs and Low to Moderate Needs Care Management Agencies. Support and Rehabilitation Services Provider a/k/a Specialty Provider (SP) There are two main types of Support and Rehabilitation Services providers: Generalist Support and Rehabilitation Services Providers Configure their program operations to the needs of the Child and Family Team without arbitrary limits on frequency, duration, type of service, age, gender, population or other factors associated with the delivery of Support and Rehabilitation Services. Specialist Support and Rehabilitation Services Providers Provide either a limited scope of Support and Rehabilitation Services (such as primarily specializing in respite services or skills training services) and/or services that may be designed for a specific population, age, gender, frequency, duration or some other factor (such as a service specializing in working with those with a history of displaying harmful sexual behaviors). 2 P age

Probation Officer (PO) A probation officer works for the criminal justice system, supervising offenders who have not yet been sentenced for crimes or individuals who have been sentenced to probation or given suspended sentences. Serious Mental Illness (SMI) - A condition of persons who are eighteen years of age or older and who, as a result of a mental disorder as defined in A.R.S. 36-501, exhibit emotional or behavioral functioning which is so impaired as to interfere substantially with their capacity to remain in the community without supportive treatment or services of a long -term or indefinite duration. In these persons mental disability is severe and persistent, resulting in a long-term limitation of their functional capacities for primary activities of daily living such as interpersonal relationships, homemaking, self-care, employment and recreation. SMI is a classification recognized by the State of Arizona of an adult who meets specific criteria and is eligible for SMI benefits. SMI determinations are submitted by an Intake and Care Coordination Evaluator to Cenpatico. Persons who have SMI benefits only (Non-Title 19) are eligible for medication management, pharmacy, supported employment, peer support, family support, permanent supportive housing, living skills training, health promotion, transportation (screening required), personal assistance, respite care, and a dedicated recovery coach. NurseWise (NW) crisis line - Provides telephonic crisis intervention services 24 hours a day, 7 days per week. NurseWise is accessed by calling 866-495-6735. If a crisis mobile team (CMT) is needed, then the request must be telephoned to NurseWise who will triage and dispatch CMTs. SABG - SABG (Substance Abuse Prevention and Treatment Block Grant) funds are limited to children and adults who are uninsured and who have a substance use issue (defined as active substance use within the last 12 months). Funds will cover evaluations/assessments, case management/coordination of care activities, and transportation to appointments. Funds do not cover behavioral health treatment while the person is detained. Medications are not covered. Title XIX/XXI - signifies that this person is Medicaid/SCHIP eligible for behavioral health services through AHCCCS, CMDP, or KidsCare. Referral Process Voluntary Crisis Services in the Cochise County Jail When an inmate in the jail experiences a psychiatric crisis, the jail can call NurseWise and request a Crisis Mobile Team (CMT). The CMT can provide a crisis assessment and referral/recommendation to detention staff. The CMT can also provide short term crisis intervention when clinically appropriate. Written documentation of this recommendation shall be made available to detention medical or in control staff upon completion of the assessment. Please note: The CMT can only make recommendations to the jail and cannot remove a person from the jail to facilitate further treatment, 3 P age

unless a judge orders a release. If the CMT does recommend a higher level of care for a person in detention, the detention center will follow internal protocols to facilitate placement in an appropriate treatment setting. NurseWise will assist with locating an appropriate treatment setting by providing detention center, upon request, staff with bed availability at receiving psychiatric hospitals. Routine Referrals for Outpatient Treatment Title XIX If it is determined that a probationer is in need of behavioral health services, the Probation Officer may either assist the probationer by identifying local providers or assist the probationer in scheduling an intake appointment with the provider of the probationer s choice. Routine Referrals for Outpatient Treatment- Non Title 19 If the probationer is not enrolled in AHCCCS, is not currently detained, and has a substance use issue, then a referral should be made to an ICC Agency within each county that receives SABG funding. Community Reentry Program If the person is not enrolled in AHCCCS, is currently detained, and has a substance use issue, then a referral should be made to NurseWise at 866-495-6735 to access Cenpatico s Community Re-Entry program within 45 days of the person s release. Intake and Assessment 1. Upon being contacted by the probationer, the Intake and Coordination of Care Agency (ICC Agency) will arrange an intake date and time for the person. ICC Agencies will facilitate service provision for adults through the Adult Recovery Team (ART) process in accordance with the DBHS Adult Clinical Team Practice Protocol (http://www.azdhs.gov/bhs/guidance/tact.pdf.) 2. The ICC Agency will request a Release of Information from the probationer in order for the PO to receive pertinent treatment information from the ICC Agency. The PO will provide the ICC Agency with any collateral information relevant to the probationer s psychiatric states including any available self-reported hospitalizations, medications, prior psychiatric interventions, and any other pertinent supporting documentation (conditions of probation and pre-sentence report excluding criminal history and psychological evaluation). 3. Upon referral, the ICC Agency, with the cooperation of all parties, i.e. guardians, the detention center, PO, etc., shall complete the Intake within 7 days of the referral. If an SMI evaluation is requested, the outpatient provider has 7 days to conduct the assessment. 4. The first service must occur within 23 days of the initial intake and the comprehensive assessment will be completed no later than 45 days after the initial intake. If an immediate need such as current substance abuse, domestic violence, or community based sex offender 4 P age

issues are identified, then all attempts will be made to begin services within 5 to 7 days. An interim service plan shall be developed immediately after the intake. 5. When the intake is complete, the ICC Agency will contact the PO with its findings and interim plan of treatment at a maximum of no later than 7 days upon completion of the intake. The ICC Agency Dedicated Recovery Coach will make further early assessment information available to the POs as may be required for court reporting or hearings. Coordination of Care The PO will notify the ICC Agency Dedicated Recovery Coach about court hearings and probation hearings at a minimum of 5 working days prior to the scheduled event, when appropriate. The ICC Agency Dedicated Recovery Coach will make every effort to attend court hearings, either in person or telephonically, assuming that appropriate notification has been given. To ensure accurate provision of treatment services, the PO will supply reports and information to the ICC Agency with written authorization from the probationer within 7 days of the request from the ICC Agency. While Detained If an ICC Agency is identified by the person in custody during the initial intake process at the detention facility, then the jail or an officer of the court will contact the ICC Agency and communicate that the probationer is detained. 1. The jail or an officer of the court will notify the ICC Agency about coordination of care. The ICC Agency will send the probationer s medication sheet and participate in release planning activities occurring within the jail. When the probationer is released to behavioral health housing, the ICC Agency will disclose the housing site contact information to the Probation Officer (PO). 2. The ICC Agency will notify the PO of barriers to appropriate treatment delivery when SMI participants are released from jail. 3. The ICC Agency will work with the Adult Probation Department to identify persons who are newly sentenced to probation and in jail who may need a Severe Mental Illness (SMI) jail evaluation. While Living in the Community Engagement involves working with partner agencies such as the ICC Agency Dedicated Recovery Coach, the Division for Developmental Disabilities, Adult Protective Services and/or RSA-Vocational Rehabilitation Services and requires that there is a full understanding of the objectives of all agencies involved. Ongoing efforts must be made to clearly understand each agency s concerns and aspirations 5 P age

for the enrolled participant. If it is identified that Adult Probation is involved, the ICC Agency shall continuously make efforts to include the assigned Probation Officer in the Adult Recovery Team process. 1. Medication sheet, if applicable, plus any assessments to the PO within seven (7) working days of completion of the ART meeting. If additional information is needed, the PO will contact the ICC Agency. 2. The ICC Agency shall provide the PO with monthly treatment summaries outlining the person s progress towards identified, measurable treatment goals. 3. The ART facilitator must assist the person in the recovery process, probation and court proceedings and aid with understanding decision-making processes by the team. 4. The PO will participate in the development and ongoing review/revision of The Treatment Plan through participation at ARTs and ongoing coordination of care with the ICC Agency. 5. The PO will provide the Adult Recovery Team Facilitator with a copy of terms of probation and modifications or amendments to these terms. The PO will share the results of the Offender s Screening Tool (OST) with the ART Facilitator for the purpose of developing collaborative service and support plans. When updates are made to the case plan, consideration will be made to incorporate the ICC Agency treatment plan. 6. If the assigned PO is not able to attend an ART meeting, the PO will contact the ICC Agency Case Manager prior to the gathering to communicate updates and valuable information for the team discussion. The Cochise County Adult Drug Court The Cochise County Adult Drug Court uses the coercive power of the courts to counter the often devastating effects of drugs on individuals and the community. Drug Court currently serves the Sierra Vista area, with plans to expand to other regions, once an adequate funding stream is secured. It is a specialized caseload managed by a probation officer. The Drug Court Team consists of attorneys, a Superior Court judge, probation personnel, treatment providers and law enforcement. Each week, the team staffs new cases and reviews the progress of Drug Court clients, making recommendations for rewards and sanctions to the Drug Court judge. Individuals are referred to Cenpatico substance use programs through the Cochise County Adult Drug Court once eligibility has been assessed and a complete pre-screening has been done with program personnel. (Please refer to the Provider Manual for eligibility requirements.) All individuals who are referred to treatment must complete a full behavioral health assessment prior to being admitted to the program to further assess the individuals substance use and treatment histories, medical and behavioral health concerns, ancillary needs, and diagnosis. During this assessment individuals also develop treatment and crisis plans and are oriented to the program in which they are enrolling. 6 P age

If an offender successfully completes the program, then the period of probation, which originally may have continued past the completion point of the Drug Court program, may be terminated. The Intake and Coordination of Care Agency (ICC Agency) will provide updates to the Probation Officer (PO) and Adult Recovery Team (ART) regarding the person s progress in the program. Ongoing Collaboration The Cenpatico Stakeholder Liaison will meet on an ad hoc basis with probation staff in each county to discuss issues, provide training, and disseminate data reports as appropriate from the previous quarter. In addition, Cenpatico meets with Cochise County Adult and Juvenile Probation on a monthly basis (last Tuesday of each month) to discuss barriers or system issues. The Chief of Probation or designee(s) will attend quarterly meetings with Cenpatico to discuss issues, questions, or observations. Issue Resolution All persons involved with Cenpatico 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 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. Both parties agree that it is preferred that problems be addressed in real time whenever possible. 1. Attempts to resolve issues at the local level should occur through the ART process but may also include contacting the ICC Agency Supervisor or Director. 2. System-level issues may be reported to either Cenpatico or to Adult Probation for review at local or regional collaborative meetings. Consultation is also available at the regional level by contacting the Cenpatico Stakeholder Liaison. 3. Complaints pertaining to member specific situations can be reported to Cenpatico through member services at 866.495.6738. 4. If issues cannot be resolved at these levels, then please 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. The ICC Agency Listing is available on the home tab Find a Provider on the Cenpatico website http://www.cenpaticoaz.com/. 7 P age

Signature Page Collaborative Protocol between Cenpatico of Arizona and Cochise County Adult Probation Effective Date: 01/01/2015 Last Revision Date: 11/12/2014 Cased on ADHS Contract Number: HP432188 End Date (if applicable): To be reviewed in one year Cenpatico CEO: Terry Stevens Cochise Co. Chief Probation Officer: Ed Gilligan Court Administrator: Eric Silverberg Date Date Date 8 P age