Arizona Mental Health Rights Documents

Knowing your RIGHTS is powerful for you and helps your providers meet your individual needs.  These documents are provided by  AHCCCS’ Office Of Individual and Family Affairs (OIFA), the Center for Disability Law, and AHCCCS’ Office of Human Rights.  We are providing these documents because we believe that self-advocacy is powerful. Print and take these flyers to your clinic to remind them of your rights.

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Enity
EveryoneAre You Seeking Substance Use Treatment?If you have used substances like prescriptions, alcohol, marijuana, opiates/heroin, and all other illicit/synthetic drugs in the last 12 months or are currently actively using these substances, treatment options are available, even if you are underinsured or uninsured.OIFA
AdultHow To File A Grievance For Arizona Long Term Care Services (ALTCS) Members with a Serious Mental Illness (SMI) DeterminationMembers enrolled in the Arizona Long Term Care System (ALTCS) who are determined to have a serious mental illness (SMI) are entitled to extensive rights.OIFA
EveryoneOHR Special Assistance DeterminationThe criteria for Special Assistance designation are: · The Member must be determined to have a Serious Mental Illness (SMI); and, · The Member is unable to communicate preferences and/or participate effectively in ISP, ITDP, grievance and/or appeal processes; and, · The Members’ inability described above is due to a specific condition: a) cognitive ability/intellectual capacity; b) language barrier that cannot be addressed by a translator/interpreter; c) a medical condition (including severe psychiatric symptoms); and/or, d) an Arizona Court has determined Full and Permanent Legal Guardianship for the Member.Office of Human Rights
ChildrenFoster and Kinship Caregivers ResourcesTen page booklet providing information on rescources for Foster and Kinship Caregivers.OIFA
EveryoneSerious Mental Illness (SMI) Decertification

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Serious Mental Illness (SMI) is a chronic and long term mental health condition which impacts a person’s ability to perform dayto-day activities or interactions. When an individual meets criteria for an SMI, it is called an SMI designation. An SMI designation will remain in place unless an individual requests to have it removed. The individual requesting removal could be the person with an SMI designation, his or her legal guardian, or a member of the individual’s clinical team. If an individual does not agree with an SMI designation, he or she can ask for an assessment to see whether they still meet criteria for an SMI designation. This process is called “decertification.”OIFA
EveryoneJacob’s Law TrainingArizona House Bill 2442 was passed into law in 2016, and helped to correct many issues facing foster, kinship and adopted children who receive behavioral health services.OIFA
EveryoneWhat is the Office of Human Rights Office? Power PointPower Point explanation of the AHCCCS Office of Human Rights.Office of Human Rights
EveryoneHow to Update Your Mailing AddressAHCCCS sometimes sends information to your mailing address. It is YOUR responsibility to notify AHCCCS when your address changes.OIFA
EveryoneNon Emergency Medical Transportation (NEMT)Non Emergency Medical Transportation (NEMT) is a covered service for Medicaid members who do not have their own transportation or means to arrange for their own transportation.OIFA
EveryoneOHR SMI Individual Service PlanningWhat is an Individual Service Plan (ISP)? The SMI Rules provide individuals in Arizona with a Serious Mental Illness the right to an assessment and an Individual Service Plan (ISP).Office of Human Rights
EveryoneStandards Appointment Availability For All AHCCCS Members


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Your AHCCCS health plan is required to ensure that you can see medical professionals in a timely manner. The following standards apply to Primary Care Providers (PCP), Specialist, Dental, Maternity, and Behavioral Health providers.OIFA
EveryoneWhat is the HIE?The Health Information Exchange (HIE) connects the Electronic Health Record (EHR) systems of providers and clinicians allowing them to securely share health information with other providers and better coordinate care. In the past, doctors used paper medical records. Now, doctors are keeping your medical records electronically. The HIE allows doctors, nurses, pharmacists, and other health care providers to access and share patient medical information electronically. Patients include all AHCCCS members.OIFA
EveryoneHow to File a Grievance as a Person with Serious Mental Illness and a RBHA MemberA grievance is a way for a person to complain about something related to his or her mental health services. By filing a grievance, you are officially asking for someone to look into your complaint.Center for Disability Law
AdultGuiding Principles for Recovery-Oriented Adult Behavioral Health Services and SystemsThe Nine Guiding Principles below were developed to provide a shared understanding of the key ingredients needed for an adult behavioral health system to promote recovery. System development efforts, programs, service provision, and stakeholder collaboration must be guided by these principles. We must utilize these principles to guide our decision making process and our interactions with each other.OIFA
AdultOHR SMI Complaints Appeals and Grievance EducationIf you have been determined to have a Serious Mental Illness (SMI) and have concerns about the treatment you receive from Arizona’s public behavioral health care system, you have access to several options to help you address your concerns. Deciding which option to use depends on the nature of the issue, what result you want, and how much time you can spend on the issue. This educational document provides basic information about what options are available to you and how to use them.Office of Human Rights
EveryonePeer-Run OrganizationsPeer-run organizations are service providers owned, operated and administrated by persons with lived experiences of mental health and/ or substance use disorders. These organizations are based in the community and provide support services. AHCCCS members have the right to request services provided by and/or participate in programs at a peer-run organization.OIFA
ChildrenMedical Coverage for Youth Transitioning from Foster CareYouth in foster care receive health care coverage from the Comprehensive Medical and Dental Program (CMDP) health plan. When a member in foster care turns age 18, AHCCCS will automatically assess whether the member qualifies for health care coverage under a different program. Members with a non-qualified immigration status will be approved for Federal Emergency Services coverage.OIFA
EveryoneOHR Educational HandoutProviding advocacy to individuals determined to have a Serious Mental Illness (SMI) to help them understand, protect and exercise their rights, facilitate self-advocacy through education and obtain access to behavioral health services in the public behavioral health system in Arizona.Office of Human Rights
EveryoneAppeal Process for Persons with A Serious Mental Illness – A Self Advocacy GuideThe purpose of this guide is to provide general informaiton to indivuals regarding their rights and protections under the law.Center for Disability Law
EveryoneHow to Access Behavioral Health ServicesAll AHCCCS members are eligible to receive medically necessary behavioral health services. These services include, but are not limited to: Behavioral health screenings and assessments, case management, psychotropic medications, crisis services (free of charge for everyone), counseling and therapy, substance use treatment, peer support services, and family support services. OIFA
AdultSharing Health Information With Family And Friends Of Adult MembersThe Health Insurance Portability and Accountability Act (HIPAA) is the Federal law that protects your personal health information (PHI). HIPAA allows you to access health care with the assurance that your personal information will be kept confidential.OIFA
AdultYour Rights as a Person with Serious Mental Illness — A Self-Advocacy GuideThe purpose of this guide is to provide general information to individuals regarding their rights and protections under the law. It is not intended as a substitute for legal advice. You may wish to contact the Arizona Center for Disability Law or consult with a lawyer in your community if you require further information.Center for Disability Law
ChildrenAHCCCS Members Under 21 Years of Age Have Dental CoverageAll AHCCCS members under the age of 21 are assigned to a Dental Home by their health plan. A Dental Home is a dental office.OIFA
ChildrenAHCCCS Members Under 21 Years Of Age Have Eyeglass CoverageDid you know AHCCCS covers eyeglasses and replacements for AHCCCS members who are under the age of 21? Vision services for all AHCCCS members under the age of 21 include regular eye exams and vision screenings, prescription eyeglasses, and repairs or replacements of broken or lost eyeglasses.OIFA
ChildrenWIC Benefits for Foster & Adopted ChildrenChildren in Arizona foster care and adopted out of Arizona foster care who elected to receive Arizona Health Care Cost Containment System, State Medicaid insurance post-adoption, are automatically eligible for WIC benefits from birth to age five.OIFA
ChildrenTip Sheet: Youth with Intellectual/Developmental Disabilities (I/DD) Transitioning to AdulthoodThe transition from the children’s health care system to the adult health care system can be difficult. It is important to have support, direction and information so you are prepared for adulthood. Proper support, direction,and information can help to best prepare youth for the responsibilities in adulthood upon turning 18 years old. OIFA
EveryoneALTCS Services & BenefitsThe Arizona Long Term Care System (ALTCS) is the State of Arizona’s Medicaid program that provides long term care services, at little or no cost, to financially and medically eligible Arizona residents who are aged, blind, disabled, or have a developmental, and/or physical disability.OIFA
EveryoneServices for AHCCCS Members Without a Serious Mental IllnessCovered behavioral health services include, but are not limited to: Counseling and Therapy, Skills Training, Supported Employment, Case Management, Personal Care Services, Family Support, and Peer Support.OIFA
EveryoneCase Management Services for AHCCCS Complete Care (ACC) and Regional Behavioral Health Authority (RBHA) MembersCase Management Services for AHCCCS Complete Care (ACC) and Regional Behavioral Health Authority (RBHA) Members. Behavioral health case management services are available to all AHCCCS members as medically necessary.
case management is a supportive behavioral health service that uses communication and resource coordination to improve treatment outcomes and achieve long term recovery goals.
OIFA
EveryoneOHR SMI Rights Education The intent of this brochure is to provide general information to individuals determined to have a Serious Mental Illness in Arizona’s public behavioral health system regarding their rights. It is not intended as a substitute for individual guidance or advice. Additionally, the AHCCCS/DCAIR, Office of Human Rights is not a law firm.Office of Human Rights
EveryoneAHCCCS Housing ProgramSafe, stable, secure housing is a basic need that impacts every aspect of physical and mental health. Although the federal Medicaid program does not pay for housing, the State of Arizona allocates limited funding to AHCCCS to provide housing subsidies to members with a Serious Mental Illness (SMI) designation, and a limited number of members with General Mental Health/Substance Use (GMH/SU) behavioral health needs. OIFA
EveryoneDual Eligible MembersAHCCCS is Arizona’s State Medicaid Program. AHCCCS Members who also have Medicare are called Dual Eligible Members. Being enrolled in the same health plan for Medicare and Medicaid is called “alignment.”OIFA
ChildrenAppeal Rights for Title 19/AHCCCS Children’s Behavioral Health ServicesThe purpose of this guide is to provide general information to individuals regarding their rights and protections under the law. It is not intended as a substitute for legal advice. You may wish to contact the Arizona Center for Disability Law or consult with a lawyer in your community if you require further information.Center for Disability Law
ChildrenBehavioral Health Respite in the Children’s SystemRespite is a covered service meant to prevent a crisis or any negative physical or emotional effects for the family caregiver and child. It is designed to ensure the well-being of the family by providing a time for rest and relief for the family caregiver while engaging the child in meaningful activities.OIFA
AdultNon-Title XIX SMI
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Adults with a Serious Mental Illness (SMI) designation, and children designated with a Serious Emotional Disturbance (SED), are eligible to receive a number of medically necessary mental health and/or substance use services, even if they are not eligible for AHCCCS. TOIFA
AdultSMI Benefits
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Individuals with a Serious Mental Illness (SMI) designation have access to additional support and resources.OIFA
ChildrenGetting Transportation to and from Your AHCCCS Covered ServicesNon Emergency Medical Transportation (NEMT) is a covered service for Medicaid members who do not have their own transportation or means to arrange for their own transportation.OIFA
EveryoneOIFA at AHCCCS


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Since 2007, OIFA’s mission has been to ensure the voices of those who receive behavioral health services and their families are heard at every level of Arizona’s public behavioral health system. Each OIFA Team Member brings their unique lived experiences to their role as peers and/or family members involved with mental health, justice, substance use and foster care.OIFA
EveryoneWait lists for AHCCCS Covered Behavioral Health Services are PROHIBITED
NO Wait Lists


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You have a right to receive the services you need, delivered within AHCCCS Policy established timelines. If an agency or specialist is unable to serve you, the agency or specialist should refer you to your AHCCCS Health Plan to locate a provider near you.OIFA
AdultAdult Family Support is Key to RecoveryDo you support someone with a mental health or substance use disorder? We can help you understand what a behavioral health diagnosis means and how the behavioral health care system works.OIFA
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EveryoneHow to Keep Yourself and Others Safe When Calling 9-1-1

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Calling 9-1-1 for help during a mental health emergency can be very stressful. Law enforcement and other responders need to have all the right information in order to help you quickly and safely. Ask the 9-1-1 operator if a CIT (Crisis Intervention Team) officer, who specializes in responding to mental illness emergency situations, is available. Alternatively, you may consider calling the Crisis Line where an operator can assist with a Crisis Mobile Team if one is required.OIFA
AdultOHR SMI Appeals ProcessThe SMI appeal process is available to individuals determined to have a Serious Mental Illness (SMI) and to individuals disputing a SMI eligibility determination. This educational document covers who can file an appeal, what issues can be appealed and the steps involved in the process.Office of Human Rights
ChildrenBehavioral Health Services for Children in Foster, Kinship & Adoptive CareAHCCCS is committed to ensuring the availability of timely, quality health care for children in out of home placement and adopted children. AHCCCS has behavioral health appointment standards in contract to ensure access to services are delivered in a timely fashion.OIFA
EveryoneAHCCCS OversightThere are several layers of oversight for the Medicaid program to fulfill its purpose. Each of these layers does its part and ultimately supports the end goal: Providing comprehensive, quality health care to those in need.OIFA
AdultHow to Become a Peer Recovery Support SpecialistA Peer and Recovery Support Specialist (PRSS) is someone with lived experience of behavioral health and/or substance use recovery who has received specialized training on how to use their experience to help others. A PRSS works with individuals during their recovery journey, sharing skills, coaching, and providing support.OIFA
Children12 Guiding Principles in the Children’s System of CareThe “Arizona Vision,” for children is built on twelve principles to which ADHS and AHCCCS are both obligated and committed. The Arizona Vision States: In collaboration with the child and family and others, Arizona will provide accessible behavioral health services designed to aid children to achieve success in school, live with their families, avoid delinquency, and become stable and productive adults. Services will be tailored to the child and family and provided in the most appropriate setting, in a timely fashion and in accordance with best practices, while respecting the child’s family’s cultural heritage.OIFA
EveryoneBe Your Own Advocate

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You Have Voice and Choice In Your Health Care Decisions. You are your best advocate. Speak up to ensure that you receive the medical and behavioral health services that you need. You are a vital part of a service delivery team and an equal partner in the planning and delivery of services.OIFA
ChildrenFamily-Run Organizations Providing Children’s ServicesAs the caregiver of a biological, foster, kinship or adopted child, you have covered services available at no cost to you from many different agencies. Some of these agencies are family-run organizations.OIFA
EveryoneSpecial Assistance FAQSpecial Assistance is the support provided by a designated representative, to a member who is unable, due to a specific condition, to communicate his/her preferences and/or to participate effectively in the development of his/her service plan, discharge plan, the Serious Mental Illness (SMI) appeal process and/or SMI grievance/investigation process.Office of Human Rights
AdultSMI Grievance ProcessAHCCCS members who have a Serious Mental Illness (SMI) designation have specific rights when it comes to behavioral health services. As stated in Arizona Administrative Code, individuals with an SMI designation have the right to:OIFA
EveryoneHow to File an Appeal of a Health Care Coverage DecisionAn appeal is a request from an applicant, member, provider, health plan, or other approved entity to reconsider or change an adverse decision, also known as an action.
An action includes any denial, reduction, suspension, or termination of a service or benefit, or a failure to act in a timely manner.
OIFA
AdultYour Rights as an Individual with an SMI Designation
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ndividuals with a SMI (Serious Mental Illness) designation have all the rights of every other citizen plus they have additional rights. These specific additional rights are in the Arizona Revised Statues (A.R.S.) chapter 5, article 2, section 36-504 through 36-514.OIFA
EveryoneNo Medication Copays for Members With A SMIIndividuals with a Serious Mental Illness determination do NOT have to pay any copays or cost sharing for behavioral health medications (when dispensed by an AHCCCS-registered provider) even if you do not have Medicaid coverage (AHCCCS).OIFA
EveryoneYour Rights as a Patient of a Behavioral Health FacilityKnowledge is Power Your Life Your TreatmentCenter for Disability Law
EveryoneHow A Hospital Discharge Plan Helps AHCCCS Members Return To Good HealthDischarge planning begins as soon as you are admitted to the hospital. It helps your health care providers coordinate your treatment and helps you make a smooth return to your community and your regular routine.OIFA
ChildrenCoverage for Youth Transitioning out of Foster CareWhen a member in foster care turns age 18, AHCCCS will automatically assess whether the member qualifies for health care coverage under a different program. Coverage will change from Mercy Care DCS CHP to an AHCCCS Complete Care (ACC) Plan.OIFA
AdultFiling a Complaint Regarding Services for Adults with a Serious Mental Illness (SMI)When you file a complaint, you are saying that you are not satisfied with the services being provided or the way an AHCCCS member is being treated. Filing a complaint brings attention to the problem so that it can be resolved.OIFA
EveryoneThe Serious Mental Illness (SMI) Determination ProcessThe SMI determination is the process individuals go through to receive an SMI designation. An individual can request to be evaluated/considered for services.OIFA
EveryoneSubstance Use Treatment OptionsIf you have used substances like prescriptions, alcohol, marijuana, opiates/heroin, and all other illicit/synthetic drugs in the last 12 months or are currently actively using these substances, treatment options are available, even if you are underinsured or uninsured.OIFA
EveryoneWhat is Special Assistance?Special Assistance is a term used to describe additional supports reserved for those with a Serious Mental Illness who are determined by the Clinical or Inpatient Team and meet specific criteria.OIFA
AdultEmployment ServicesEmployment services are available for Medicaid-eligible individuals, of all ages, receiving Behavioral Health or Division of Developmental Disabilities (DDD) services. These are services that can help members prepare for employment or maintain employmentOIFA
EveryoneCourt-Ordered Mental Health Evaluation and Treatment in Arizona: Rights and ProceduresThe purpose of this guide is to describe the court-ordered evaluation and treatment process. This guide will also explain the legal rights people have who are going through that process.Center for Disability Law
ChildrenCrisis Services for Children in Foster, Kinship & Adoptive CareA crisis is any situation in which a person’s behaviors puts them at risk of hurting themselves or others and/or when they are not able to resolve the situation with the skills and resources available.OIFA
AdultOHR SMI Inpatient Rights EducationAs a person determined to have a SMI, you have a number of rights. The Office of Human Rights educational document “Your Rights” outlines these and the Arizona Administrative Code Title 9, Chapter 21 lists them in full.Office of Human Rights
AdultSMI Designation – Frequently Asked QuestionsSMI Designation – Frequently Asked QuestionsCenter for Disability Law
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