ACCESS TO GENESEE COUNTY CRISIS SERVICES IndividualCommunity Agency .

ACCESS TO GENESEE COUNTY CRISIS SERVICES Community Agency Requests Crisis Supports on Behalf of Individual Individual Requests Crisis Supports Crisis Call Center GHS 24/7 Crisis Line CIRT Crisis Intervention & Recovery Team (810) 257-3740 Phone crisis intervention and triage provided Follow-up or alternative support referrals may be made Face-to-face crisis support provided 24-7 ACT & Home-Based Services Assertive Community Treatment (Adults) Home Based Services (Children) Consumer has active admission to a GHS Network ACT or Home Based program and makes direct call for support Hospital Emergency Department 08-2012 Consumer presents to emergency room Hospital screens for inpatient or other least restrictive crisis service needs

ACCESS TO GENESEE COUNTY CRISIS SERVICES Crisis Call Center GCCMH 24/7 Crisis Line (810) 257-3740 Crisis Needs Met With Crisis Call Center Phone Support Additional Crisis Support Needed CIRT Crisis Intervention & Recovery Team Face-to-face, community based crisis support ACT & Home Based 24/7 face-to-face and phone support for active ACT (adult) and Home-Based (children) enrolled consumers. Emergency Department 08-2012 Refer to Hospital Emergency Dept. for emergent crisis needs that are unable to be met in community.

ACCESS TO GENESEE COUNTY CRISIS SERVICES CIRT Crisis Intervention & Recovery Team GHS 24/7 Face-to-Face Crisis Support Crisis Support Provided by CIRT Face-to-face crisis intervention Brief or ongoing support, up to 30 days CIRT Refers, Links & Coordinates Warm Transfer to: Current mental health &/or substance abuse provider 08-2012 Sobering Facility CPI (Community Programs, Inc.) GHS Mental Health & Substance Abuse Access Centers Other community resources CIRT Refers for Emergent Crisis Support Inpatient Psychiatric – CIRT links to Hospital Emergency Department for admission evaluation Alternative Acute Care Services: o Crisis Residential (Adult) o Partial Hospitalization (Adult & Adolescent) o Crisis Stabilization (All Ages) CIRT mental health professional reviews eligibility and medical necessity with Utilization Management

ACCESS TO GENESEE COUNTY CRISIS SERVICES Hospital Emergency Department Hospital Evaluates Individual No Acute Care Needs Hospital makes direct referral to: CIRT CPI Sobering Facility Current mental health provider Genesee Health System and Substance Use Access Center Other community resource Acute Care Needs Identified Inpatient Psychiatric Partial Hospitalization (adult & adolescent) Crisis Residential (adult) Crisis Stabilization (all age groups) GHS is Not Payer Hospital contacts other county or payer for authorization GHS is Payer Hospital completes Inpatient Pre-Admission Review form and submits to GHS Utilization Management (UM) 08-2012 Continued on next page

ACCESS TO GENESEE COUNTY CRISIS SERVICES Hospital ED submits IPAR Form to GHS Utilization Management for eligibility and medical necessity determination UM Authorizes Inpatient Level of Care UM Denial for any Acute Service UM Authorizes Alternative Acute Service Level Hospital locates bed & informs UM of placement UM consults w/ED to facilitate appropriate alternative referrals and authorizations: UM creates authorization for hospital admission Community, non-GHS referral GHS Access Center ACT or Home-Based (currently enrolled only) CIRT (for further crisis support) Sobering Facility or CPI Other Consumer Discharged CRU Provider notifies UM of discharge and related required data by next business day following discharge UM confirms CRU bed availability and authorizes; consumer transported to CRU by CRU Provider PHP 08-2012 Crisis Stabilization UM authorizes for PHP to begin next business day UM faxes authorization to PHP next business day UM authorizes and notifies Crisis Stabilization of referral Crisis Stabilization picks individual up from ED within one hour of referral unless individual prefers next day appointment

ACCESS TO GENESEE COUNTY CRISIS SERVICES 08-2012 Additional Crisis Support Needed Emergency Department Refer to Hospital Emergency Dept. for emergent crisis needs that are unable to be met in community. Crisis Call Center GCCMH 24/7 Crisis Line (810) 257-3740 Crisis Needs Met With Crisis Call Center Phone Support CIRT