Special Assistance in Arizona for Individuals Determined to Have a Serious Mental Illness (SMI)

1. Special Assistancein Arizona for Individuals Determined to Have a Serious Mental Illness (SMI) A Self-Study Module Developed by: Office of Human Rights / Division of Behavioral Health Services and CPSA June 2012

2. Module Objectives After completing this training module you will be able to: • Describe the basics of Special Assistance. • Apply the criteria to determine whether an individual determined to have a Serious Mental Illness (SMI) is in need of Special Assistance. • Properly document this determination in the clinical record. • Follow the process to notify the Office of Human Rights. • Take steps to communicate with and involve the person providing Special Assistance in the individual’s treatment, particularly through service and discharge planning, grievances/investigations and appeals. This supports the individual in exercising and protecting her or his SMI rights. OHR/2-12-07, last revised 6-28-12

3. Module Contents • What is Special Assistance? • General Requirements for Special Assistance • Criteria for Special Assistance • Who can assess for Special Assistance? • When to assess for Special Assistance? • Special needs vs. Special Assistance • The Required Process for Providers and OHR • Ensuring Involvement • When Special Assistance ‘Ends’ • Additional Administrative Functions OHR/2-12-07, last revised 6-28-12

4. What Is Special Assistance? In a nutshell, Special Assistance is: The support and help provided to an individual with a SMI who is also unable - due to a specific condition - to communicate his or her preferences and/or to participate effectively in the development of his or her service plan, discharge plan, the appeal process and/or grievance/investigation processes. Let’s look at the requirements for the providing of Special Assistance… OHR/2-12-07, last revised 6-28-12

5. General Requirements It is important to view the Special Assistance determination as a two-step approach: • Deciding if an individual determined to have a Serious Mental Illness (SMI) meets the criteria for Special Assistance, and • If member meets criteria, notifying the Office of Human Rights (OHR) using the established process about how the individual meets criteria and whether someone is involved in the individual’s life who could provide Special Assistance. OHR/2-12-07, last revised 6-28-12

6. General Requirements:Who Can “Assess”? The Arizona Administrative Code and ADHS/DBHS policy provide that the following people/entities can determine whether an individual determined to have a SMI is in need of Special Assistance (will be referred to as “notifier” or “provider” throughout this module): • Qualified Clinician • Case Manager • Clinical Team of T/RBHAs • T/RBHA • Program Director of a Subcontracted Provider • ADHS/DBHS Deputy Director • Administrative Hearing Officer Next, a look at the criteria for a member to qualify for Special Assistance… OHR/2-12-07, last revised 6-28-12

7. General Requirements: Criteria An individual who has been determined to have a Serious Mental Illness (SMI) is in need of Special Assistance if: • According to staff qualified to make the determination, he/she is unable to do any one or more of the following: • Communicate preferences for services. • Participate effectively in service planning (ISP) or inpatient treatment and discharge (ITDP) planning. • Participate effectively in the appeal, grievance, and/or investigation processes. OHR/2-12-07, last revised 6-28-12

8. General Requirements: Criteria(continued…) • The individual’s limitations must be due to any of the following: • Cognitive ability (i.e., mental retardation; cognitive impairment; borderline intellectual functioning) • Intellectual capacity (significantly diminished capacity) • Language barrier (an inability to communicate that extends beyond what an interpreter/translator can address, this might include expressive aphasia - seen in some survivors of stroke and other situations.) OHR/2-12-07, last revised 6-28-12

9. General Requirements: Criteria(continued…) The individual’s limitations must be due to any of the following (continued…): • Medical issue (including, but not limited to, TBI, dementia, severe psychiatric symptoms that affect communication and/or cognition) • Please note- when a member is under general guardianship, or is pursing general guardianship, they automatically meet Special Assistance criteria. OHR/2-12-07, last revised 6-28-12

10. General Requirements: Criteria(continued…) • Proper application of the criteria will generally not result in identifying as Special Assistance eligible individuals who: • need things explained in simpler terms/take additional time to understand information; • are able but not willing to participate; • can speak and advocate for themselves but present with interpersonal issues that make working with them challenging; or, • need more regular and effective engagement and re-engagement. OHR/2-12-07, last revised 6-28-12

11. General Requirements: Criteria(continued…) • The following situations alone are insufficient to meet the criteria for Special Assistance: • effects of active substance use/abuse only. • being under court order because of being deemed Gravely Disabled (GD) or Persistently or Acutely Disabled (PAD) - but these can be ‘red flags’ for possible Special Assistance. Note: the actual criteria do not consider whether someone already has a guardian or family or friend involved OR whether the individual might “benefit” from having an advocate. Did you know?... special needs and Special Assistance are two very different things… OHR/2-12-07, last revised 6-18-10 OHR/2-12-07, last revised 6-28-12

12. Special Needs vs. Person in Need of Special Assistance • An individual with special needs is different from being in need of Special Assistance - even though the term sound similar! Some examples of an individual with special needs is someone who: • Does not speak English • Does not know how to read or write • Is deaf, hard of hearing, blind or has a physical disability OHR/2-12-07, last revised 6-28-12

13. Special Needs vs. Person in Need of Special Assistance (continued...) • The clinical team/T/RBHA/provider is required to arrange for a qualified interpreter/translator, staff who speak the language fluently or other reasonable accommodations to meet the individual’s special needs. • An individual who has a special need, does not generally meet the criteria for Special Assistance. A notification to OHR about an individual with a special need is not required. Note: you can have a person who has a special need and also meets Special Assistance criteria, but these two situations are generally not directly related. When are members assessed for Special Assistance needs?… OHR/2-12-07, last revised 6-28-12

14. General Requirements: When to Assess Assess for Special Assistance at the individual’s initial assessment and on an on-going basis thereafter (but only if already determined to have a SMI). Minimally, the assessment should occur: • prior to service planning meetings and reviews, • prior to discharge planning meetings and reviews, • when a grievance or an appeal is filed, or • when conditions exist that may constitute a basis for filing a grievance or an appeal. Let’s go through a couple of Special Assistance assessment/criteria scenarios… OHR/2-12-07, last revised 6-28-12

15. Special Assistance AssessmentScenario 1 - Guy Guy is a 46 year old male, on AHCCCS, who is currently in an inpatient setting. He is a person who is enrolled with a SMI, and is diagnosed with schizoaffective disorder and borderline intellectual functioning. He has a limited guardianship in place - a guardian for medical issues only (does not include psychiatric issues). Guy has difficulty remembering people, including those he has recently met, and difficulty processing ideas and thoughts. When asked a question he usually does not respond to the question and instead talks about random things, appearing as if he does not comprehend the question asked. For example, when asked if he knows what his treatment plan is his response is “I like carrots, tomatoes, broccoli, and radishes….I also buy 18 yogurts when I go to the store.” Is Guy in need of Special Assistance? Why or why not? OHR/2-12-07, last revised 6-28-12

16. Special Assistance AssessmentScenario 1 - Guy Answer Guy is a 46 year old male, on AHCCCS, who is currently in an inpatient setting. He is a person who is enrolled with a SMI, and is diagnosed with schizoaffective disorder and borderline intellectual functioning. He has a limited guardianship in place – a guardian for medical issues only (does not include psychiatric issues). Guy has difficulty remembering people, including those he has recently met, and difficulty processing ideas and thoughts. When asked a question he usually does not respond to the question and instead talks about random things, appearing as if he does not comprehend the question asked. For example, when asked if he knows what his treatment plan is his response is “I like carrots, tomatoes, broccoli, and radishes….I also buy 18 yogurts when I go to the store.” Is Guy in need of Special Assistance? Why or why not? Answer: YES Guy meets the Special Assistance criteria - due to severe symptoms of schizoaffective disorder and borderline intellectual functioning affecting his memory, comprehension and ability to provide input to his treatment. OHR/2-12-07, last revised 6-28-12

17. Special Assistance AssessmentScenario 2 - Augusto Augusto, who is on AHCCCS, is a 32 year old male who lives in his own home. He is diagnosed with major depression and PTSD and is a person enrolled with a SMI. He does not like to venture outside of his house very often, although he is willing to come to the clinic to meet. His first language is Spanish and he does not speak, read nor write English well. His service planning update meeting is scheduled for next week. He is willing to come to the clinic for the meeting as long as transportation is provided. Is Augusto in need of Special Assistance? Why or why not? OHR/2-12-07, last revised 6-28-12

18. Special Assistance AssessmentScenario 2 - Augusto Answer Augusto is a 32 year old male who lives in his own home. He is diagnosed with major depression and PTSD and is a person enrolled with a SMI. He does not like to venture outside of his house very often, although he is willing to come to the clinic for the meeting. His first language is Spanish and he does not speak, read nor write English well. His ISP update meeting is scheduled for next week. He is willing to come to the clinic for the meeting as long as transportation is provided. Is Augusto in need of Special Assistance? Why or why not? Answer: NO Augusto does not meet the Special Assistance criteria, based on the facts provided (remember that speaking another language or being unable to read or write is a special need). A quick review of Special Assistance general requirements… OHR/2-12-07, last revised 6-28-12

19. Review of General Requirements In determining whether someone meets Special Assistance criteria, it is important that the provider: • Is familiar with the individual; • Looks at the “big picture” with respect to any factors affecting the individual’s ability to participate effectively; • Recognizes that “special needs” or other factors, such as an individual who needs extensive engagement to encourage participation in recovery, do not satisfy Special Assistance criteria; • Is willing to collaborate with other providers, inpatient staff, etc.; and, OHR/2-12-07, last revised 6-28-12

20. Review of General Requirements(continued…) • If the individual meets the Special Assistance criteria - and is not currently identified as Special Assistance - the notifier must identify the individual as such and send OHR the notification form, regardless of whether there is a guardian, designated representative, family member or friend involved. Remember - it is a high hurdle to meet Special Assistance criteria (not as high as guardianship). It is meant to identify those individuals whose conditions make it so they cannot speak/advocate for themselves. Now that we have reviewed how to assess an individual for meeting Special Assistance criteria, we’ll look at the required process of establishing Special Assistance… OHR/2-12-07, last revised 6-28-12

21. Required Process - Provider The provider must: • Assess whether an individual determined to have a SMI is in need of Special Assistance using the criteria discussed in previous slides • Document in the clinical record the details: date assessed, specific circumstances considered and whether or not the individual meets criteria for Special Assistance. If they don’t, no OHR notification is necessary - just document in the file why the member did not meet the Special Assistance criteria. OHR/2-12-07, last revised 6-28-12

22. Required Process - Provider(continued...) • If the individual meets criteria, within three (3) working days of identifying the individual as in need of Special Assistance,* notify the Office of Human Rights (OHR) using the Special Assistance form (PM Form 5.4.1) Click on to open (will open in separate window) • If assistance is needed immediately, submit the notification immediately and contact OHR to inform of the urgency (completed form can be faxed to OHR: 602.364.4590). • Attempt to inform the individual about the notification. * if not already identified OHR/2-12-07, last revised 6-28-12

23. Required Process - OHR(continued...) OHR will then: • Review the information provided to ensure sufficient information to support the individual meets the basic criteria for Special Assistance and, if necessary, request additional information from the notifier. Please reply promptly to OHR requests for additional information - the notification cannot be processed until you provide to OHR the additional requested information. Note: no Release Of Information (ROI) is needed to share information with OHR to process the notification (with the exception of any information about substance use - omit or redact such). OHR/2-12-07, last revised 6-28-12

24. Required Process - OHR(continued...) • Within three working days of receipt of the notification (or, if requested, receipt of any additional information), OHR will complete and return Part B of the notification form to the clinical team and RBHA. The completed Part B will indicate: • A summary of how the person meets the basic criteria on Part B (or does not, after further review by the notifier). (OHR is not deciding whether or not person meets criteria; OHR only decides who is “assigned” to meet Special Assistance needs, taking into consideration any information the provider has shared). • The name, relationship, and contact information for the person assigned to provide Special Assistance (this could be a guardian, family member, friend, OHR advocate, etc.). Note: if OHR hasn’t contacted the notifier within 3 days, the notifier should contact OHR. Or, if it is urgent, notifier should contact OHR when sending in the form. OHR/2-12-07, last revised 6-28-12

25. Required Process - OHR(continued...) • In completing Part B, OHR determines whether someone involved can provide Special Assistance or if the individual needs an advocate assigned.* • If a guardian or another person is able to provide Special Assistance, OHR will make contact in writing to inform them of the Special Assistance status and provide information about SMI rights, OHR and the process to request assistance from OHR. • If OHR assigns an advocate, the advocate will begin to work with the individual and the team, as detailed in the upcoming ‘Ensuring Involvement’ slides. * At times, OHR assigns an advocate to jointly meet needs with an involved guardian, family member of friend. OHR/2-12-07, last revised 6-28-12

26. Required Process - Provider(continued...) Upon receipt of the form from OHR, the provider must: • Maintain all pages of the Notification for Special Assistance form (PM form 5.4.1) in the individual’s comprehensive clinical record (and good practice dictates also documenting the client as “Special Assistance” and the person providing it in the ISP, face sheet, progress notes, etc.). • Keep the person providing Special Assistance involved as required by Provider Manual 5.4. (see next slides…) Note: the form follows the individual - if change in case manager, site, provider, T/RBHA. If the provider maintains electronic records, provider must scan form and include in the records. Let’s apply what we’ve learned to another scenario… OHR/2-12-07, last revised 6-28-12

27. Required Process:Ensuring Involvement The provider must maintain open communication with the person providing Special Assistance (the assigned advocate, guardian, family member, and/or friend). The provider must contact the person(s) to involve them in: • ISP planning and reviews (including any time the individual is making decisions about service options, a service is being modified, or a service is being terminated); • ITDP planning (this includes any time a person goes into an inpatient psychiatric setting); • Investigation, grievance or appeal processes (or when filing a grievance or appeal may be warranted). OHR/2-12-07, last revised 6-28-12

28. Required Process:Ensuring Involvement (continued…) The person providing Special Assistance will: • Communicate regularly with the individual to ensure as much input and involvement as possible; • Attend meetings and provide input to the ISP (and when applicable ITDP) as a member of the team; • Help the individual understand, exercise and protect his/her rights, in particular with respect to decisions involving services; • Be familiar with the service planning, discharge planning, appeal and grievance processes and provide the individual assistance as appropriate; and, • For guardians, family or friends assigned, contact OHR for information or assistance, if needed. OHR/2-12-07, last revised 6-28-12

29. Required Process:Ensuring Involvement - OHR When OHR is newly assigned to provide Special Assistance to an individual, the advocate will contact: • the person in need of Special Assistance • the team for an update and for relevant records: • When OHR staff requests records for an individual in need of Special Assistance, OHR customarily provides an Authorization for Release of Information (ROI) signed by the client, even though it is not required (with the exception of information regarding substance use). • In the event OHR staff does not provide an ROI, the team should conclude OHR was unable to obtain an ROI and release the records with any information on substance use redacted. An Advocate begins developing a rapport, explains advocate’s role, requests ROIs (despite not being required, OHR is an individual-rights organization and almost always tries to obtain ROIs from the client/guardian, if any) and gets familiar with client’s needs and any immediate issues. OHR/2-12-07, last revised 6-28-12

30. Special Assistance AssessmentScenario 3 - Antonia Antonia is a 19 year old female who is diagnosed with bipolar disorder and cognitive impairment. She is a person enrolled with AHCCCS with a SMI as well as with the Division of Developmental Disabilities. She has a general guardian. Antonia’s cognitive impairment affects her ability to communicate and participate in service planning meetings. She currently has a potential (behavioral health) service issue that may require the filing of an appeal. Is Antonia in need of Special Assistance? - provide support for your answer. - indicate the next steps to take. OHR/2-12-07, last revised 6-28-12

31. Special Assistance AssessmentScenario 3 - Antonia Answer Antonia is a 19 year old female who is diagnosed with bipolar disorder and cognitive impairment. She is a person enrolled with AHCCS with a SMI as well as with the Division of Developmental Disabilities. She has a general guardian. Antonia’s cognitive impairment affects her ability to communicate and participate in service planning meetings. She currently has a potential (behavioral health) service issue that may require the filing of an appeal. Is Antonia in need of Special Assistance? - provide support for your answer. Answer: YES – Antonia has a general guardian and automatically meets the Special Assistance criteria (even if she had no guardian, she would meet criteria due to effect of her cognitive impairment). OHR/2-12-07, last revised 6-28-12

32. Special Assistance AssessmentScenario 3 - Antonia Answer(cont.) Is Antonia in need of Special Assistance? (YES) - indicate the next steps to take. Next Steps: 1) After checking to make sure she is not already identified, fill out notification form noting that she is under general guardianship and also the other details (DDD, cognitive issue). Be sure to include the guardian’s name, address and phone number. If you happen to have any concerns about the guardian meeting needs, share that with OHR when you send in the form. 2) Send the form to OHR - make sure that you indicate that she may have an issue that might need an appeal. Include a copy of the order/letters and acceptance with the form. 3) Keep the guardian informed - even though OHR will reach out at a minimum with an informational letter to the guardian. 4) Store the form (both Parts A & B) in the clinical file. 5) Keep the guardian involved per PM 5.4. If OHR formally assigns an advocate for the longer-term or just to address the appeal issue, keep that person involved appropriately also. OHR/2-12-07, last revised 6-28-12

33. Required Process: When Special Assistance “Ends” What happens when an individual no longer meets criteria for Special Assistance? • The notifier/provider must notify OHR within ten days of the determination that the individual no longer meets criteria using Part C of the notification form - PM Form 5.4.1 (the original from the clinical file). • The notification must include: • the reason(s) that the individual no longer meets the criteria to be in need of Special Assistance; • the effective date; • the date the form is completed; and • The name, position and contact information of the person submitting the form. Some examples of no longer meeting Special Assistance criteria… OHR/2-12-07, last revised 6-28-12

34. Required Process: When Special Assistance “Ends” Reasons Special Assistance might end (requires utilization of Part C of the notification form): • At times individuals no longer meet the criteria… • Because no longer has condition or resulting effect on communication/participation • Because no longer is enrolled: • Due to move to ALTCS and disenrollment • Due to passing away • Due to move out of state • Due to imprisonment - for Department of Corrections (DOC) only (not jail stays) • Note: a person who transfers to another T/RBHA or provider has the Special Assistance status follow them (but can later no longer meet criteria unrelated to the transfer). • Note: if OHR is assigned, the team must discuss the need for a Part C with the advocate prior to doing one OHR/2-12-07, last revised 6-28-12

35. Applying the Concepts The following slides will present three final scenarios which will provide you the opportunity to apply the concepts and procedures presented in this module. Take a moment and consider your answers before reviewing the answers provided. OHR/2-12-07, last revised 6-28-12

36. Scenario 4 - John John is a 35 year old male diagnosed with PTSD has a traumatic brain injury (which affects his general cognitive ability), is a person with a SMI and is identified as in need of Special Assistance. The Office of Human Rights has an advocate assigned to provide Special Assistance. He lives in his own apartment. He and his advocate recently arranged with the case manager to start the inter-RBHA transfer process as John is relocating to another GSA and RBHA in Arizona. What is the current provider’s obligation because John is Special Assistance? What is the receiving provider’s obligation? OHR/2-12-07, last revised 6-28-12

37. Scenario 4 - John Answer What is the current provider’s obligation because John is Special Assistance? The case manager must: a. keep the advocate involved during the provider transfer process b. must ensure that the receiving provider/RBHA: 1) is aware that John is Special Assistance, 2) include the original notification form (both pages with Part A & B) with the rest of the transfer paperwork, 3) gives the receiving provider the advocate’s name and contact information. What is the receiving provider’s obligation? The receiving provider must ensure that: a. there is a recognition that John’s Special Assistance status follows him and thus, the advocate is kept involved as required upon the client’s transfer - in particular, at the initial intake appointment. b. the notification form is maintained in the clinical file. Let’s consider some other questions regarding John… OHR/2-12-07, last revised 6-28-12

38. Scenario 4 - John Additional Considerations What are the respective obligations if instead- John asks to transfer within the same GSA/RBHA to another provider? Answer: The case manager must: 1) contact the advocate to make sure aware of John’s request for a transfer and wait to start process until the advocate lets the case manager know what John’s final decision is. 2) if advocate verifies John has made an informed decision to transfer, keep the advocate involved during the provider transfer process. The receiving provider must ensure that: 1) they recognize that John’s Special Assistance status follows him and thus 2) the advocate is kept involved as required upon the client’s transfer 3) the notification form is maintained in the file. OHR/2-12-07, last revised 6-28-12

39. Scenario 4 - John Additional Considerations What are the respective obligations if instead- the current provider plans to assign John to another case manager and/or doctor? Answer: Unless the advocate is involved with a request to change case manager or doctor, the case manager must contact the advocate to ensure John discussed the request with the advocate and that the request can move forward. If so, the case manager must: 1) keep the advocate updated on the status of the re-assignment, 2) ensure that the receiving case manager/doctor are aware that John is Special Assistance, 3) ensure that they have the advocate’s contact information, and 4) double-check that the notification form is in the clinical file, as John’s Special Assistance status follows him. OHR/2-12-07, last revised 6-28-12

40. Scenario 4 - John Additional Considerations What are the respective obligations if instead- John moved out of state and the provider/RBHA plans to close his enrollment? Answer: Generally the advocate will be aware of client’s move out of state and would have helped the client plan for the move, along with the case manager and provider. If the case manager has reason to believe that the advocate is not aware of the move, inform the advocate as soon as possible and prior to closing out John. Also, the T/RBHA should have a mechanism to contact the provider and person providing Special Assistance to verify that the Special Assistance client in fact should be closed (for whatever reason - move out of state, death, etc.) as part of the re-engagement/closure process. In this instance, the provider must fill out Part C (please use the original form’s Part C) and return it to OHR (generally within 10 days, but if an appeal is likely or has been filed regarding the provider/RBHA closure, wait until the 60 day appeal window has passed and/or the appeal ends). OHR/2-12-07, last revised 6-28-12

41. Scenario 5 - Jerry Jerry is a 60 year old male with anxiety disorder and some dementia-like symptoms, is enrolled with a SMI and is currently identified as in need of Special Assistance. His brother is assigned to provide Special Assistance. Jerry lives in a supported apartment setting and attends counseling sessions weekly and a peer clubhouse setting three days a week. He recently told his therapist, who is co-located at the case management provider site, that he no longer wants to be in counseling. He also told her that he only wants to go to the peer clubhouse once per week. The therapist cancels his next counseling session and encourages him “to do what he thinks is best for himself.” Did the therapist act accordingly here? Why or why not? OHR/2-12-07, last revised 6-28-12

42. Scenario 5 - Jerry Answer Did the therapist act accordingly here? Why or why not? The therapist should let the case manager know about Jerry’s statement and they can decide who will notify the brother. They should encourage the brother to discuss with Jerry his desire and let the case manager know what Jerry decides to do about the counseling and the peer clubhouse participation. Neither the therapist nor the case manager can take any steps to modify the services prior to involvement of the brother who is providing Special Assistance. This is to ensure that Jerry is making a well-informed decision. The case manager and/or therapist can call a staffing, if needed and/or discuss with Jerry and with his brother why Jerry wants these changes and to make sure that other options are explored (such as counseling sessions on a lesser frequency, changing the focus of the sessions, changing therapists, etc. and other options to meaningful day activities - perhaps he is ready to volunteer or get a job instead of going to the clubhouse). OHR/2-12-07, last revised 6-28-12

43. Scenario 6 - Juanita Juanita is a 55 year old female who has schizoaffective disorder, is enrolled with a SMI and is identified as in need of Special Assistance. The Office of Human Rights assigned an advocate to provide Special Assistance and assist a family member guardian, who does not always put Juanita’s needs first. She lives in a residential placement but was just admitted to an inpatient setting. What are the obligations of the case management provider with respect to ensuring involvement of the people providing Special Assistance? OHR/2-12-07, last revised 6-28-12

44. Scenario 6 - Juanita Answer What are the obligations of the case management provider with respect to ensuring involvement of the people providing Special Assistance? 1) Notify both OHR advocate of guardian ASAP upon her admission - facility, unit and Social Worker, if known. 2) Let inpatient facility know (and provide original notification form A/B for their clinical record) that Juanita is Special Assistance and share contact information for guardian and OHR. 3) Keep OHR and guardian in the loop on all discharge planning meetings and/or discussions, to ensure that they can communicate with Juanita to get her input and attend discharge planning meetings. This means that discharge planning meetings must be scheduled with their availability in mind and that a discharge plan cannot be finalized until they have given input. OHR/2-12-07, last revised 6-28-12

45. OHR’s Special Assistance-Related Administrative Functions • OHR maintains a list of individuals in need of Special Assistance, the areas of need, who is addressing the needs and other relevant data. • OHR prepares reports as follows: • Monthly reports for the Human Rights Committee for each region • Quarterly reports for each T/RBHA. • OHR reviews grievances and appeals filed by individuals in need of Special Assistance and as needed, provide assistance in resolving them. OHR/2-12-07, last revised 6-28-12

46. CPSA’s Special Assistance Administrative Functions • The CPSA is required to maintain data on individuals in need of Special Assistance and work with OHR to keep the data as up-to-date as possible. • Case management providers must follow the internal process for reporting to the CPSA Administration: • The reporting of new Special Assistance individuals or transfers; • The updating of changes to individuals’ information whose guardian, family member, or friend is providing Special Assistance, including but not limited to: • Individual’s contact information • Assigned case manager: name and contact information • Person meeting the needs: name and contact information OHR/2-12-07, last revised 6-28-12

47. Other Requirements • The Human Rights Committee (HRC) for the region is responsible for making regular visits to the residential settings of Special Assistance individuals to ensure that their needs are being met and to determine their satisfaction with the care. • HRC members do not need an Authorization for Release of Information (ROI) in order to visit individuals in need of Special Assistance. • HRC members generally need a ROI to view individuals’ records. • The individual, a guardian or a designated representative can appeal the determination that a person needs (or does not need) Special Assistance through the SMI appeal process. OHR/2-12-07, last revised 6-28-12

48. Resources • Arizona Administrative Code, R9-21-101.B.13 and R9-21-301.C.1 & 2 (www.azsos.gov/public_services/Title_09/9-21.htm) • Special Assistance Summary (on OHR webpage) • DBHS Policy and Procedures GA 3.4 (www.azdhs.gov/bhs/policy.htm) • CPSA) Provider Manual section 5.4 http://204.17.36.18/docs/5.4(12-1-10).pdf • Office of Human Rights Webpage (www.azdhs.gov/bhs/ohr.htm) OHR/2-12-07, last revised 6-28-12

49. Contacts & Acknowledgments If you have questions about Special Assistance, contact CPSA Member Services (520) 318-6946 or provider or call the Office of Human Rights (OHR) at: PhoenixTucson Flagstaff 602-364-4585 520-770-3100 928-214-8231 800-421-2124 877-524-6882 877-744-2250 The OHR prepared the original version of this training (2007) with input from each of the RBHAs. It is updated periodically, with the current version available on the OHR webpage of ADHS/DBHS website: www.azdhs.gov/bhs/ohr.htm. OHR/2-12-07, last revised 6-28-12

50. Final Exam You have completed the content portion of this Special Assistance module. Please complete the Final Exam at this time. OHR/2-12-07, last revised 6-28-12