Appendixes

Appendix A

Access Services for People with Mental Illness In Schenectady County

Monday, 2 March 2013 at 20:30 EST, by SiteAdmin


 
1. Referrals are needed for specialized licensed housing, case management and Assertive Community Treatment (ACT) programs. These are made through the County’s Single Point of Access (SPOA) process. SPOA referrals are reviewed and forwarded to programs by the SPOA Coordinator, who is housed in the Schenectady County Office of Community Services.
 
Please note: The SPOA Coordinator does not make admission decisions. Admission decisions are made by the provider. Admissions criteria are established by the New York State Office of Mental Health (OMH) regulations. Most OMH licensed programs require that individuals be in treatment as an admission criteria. Thus, referrals generally require information that can only be provided by the agency providing clinical treatment to your family member.
 
If you have a question regarding your family member’s eligibility for specialized licensed mental health housing, case management or ACT services, you should contact your family member’s clinical provider. If you have general questions regarding the SPOA process, you may contact the SPOA Coordinator, Sean Tuckey or the SPOA Supervisor, Ray Hare at518-386-2218 .
The YMCA offers some specialized housing for men with a severe mental illness. You can contact  518-374-9136  for more information.
 
Other options include apartments administered by the Schenectady Municipal Housing Authority (SMHA). Section 8 is a rent subsidy program. The Section 8 recipients pay 30% of their monthly income toward rent, and the Section 8 voucher pays the remainder. Please note that the waiting list for a Section 8 voucher is generally long so Section 8 is normally not available if your family member is in immediate need of housing assistance. You may contact the SMHA at  518-386-2000.
 
2.For mental health clinic or continuing treatment services call Ellis Mental Health Clinic
at518-243-3300   for an intake appointment with a counselor and/or psychiatrist, or have your doctor make this referral.
 
For individuals in managed care plans, you may need referrals from either your plan or from a primary care physician. Patients who wish to have services from CDPC’s Franklin Street Clinic or Prepaid Mental Health Plan should call them directly at518-374-3403.
When your friend or family member is being treated by a doctor or at a community mental health agency and you believe the person’s condition is deteriorating, contact the doctor or therapist to discuss your concerns. If necessary, the treating therapist should assist you in initiating the process to have the person evaluated for inpatient admission.
 
3. Hospital admission is either voluntary or involuntary. Ellis Hospital operates mental health crisis services through Ellis Hospital’s emergency room. Crisis services may be accessed through calling  518-243-3300 . If your family member voluntarily needs and wants a crisis evaluation, your family member should go to Ellis Hospital’s emergency room. If a doctor determines that your family member needs inpatient care, and your family member agrees to admission, your family member will be voluntarily admitted for inpatient care.
If the person needs inpatient care but refuses voluntary admission, the doctor may admit the patient involuntarily. The criteria for an involuntary admission are stipulated in New York State’s Mental Hygiene Law and a physician’s decision to involuntarily admit a patient must be in accord with the provisions of the law. Please note: All decisions on whether a patient is appropriate for inpatient services as well as whether a patient should be voluntarily or involuntarily admitted are made by a physician.
 
4. Police assistance: There are other means whereby someone can support a family member in crisis as follows: Important: If there is an immediate threat to harm to self or others, you should immediately access emergency police assistance by dialing 911. Advise the emergency responder as to the nature of the threat and that the person is suffering from a mental illness.
When the police arrive, they will use their discretion to decide whether the situation warrants further legal intervention. They may judge that the individual needs to go to a hospital or be taken into custody. The police may decide that the circumstances warrant no further legal intervention. Ideally, family members or friends will be able to influence the decision in the direction of seeking medical treatment rather than incarceration, but this is not always possible.
If you do not believe there is an immediate threat to harm self or others, you may contact Ellis Crisis Services to discuss your concerns.
 
Finally, you may contact your family member’s mental health provider and voice your concerns. If the mental health provider believes your family member’s conditions meets the legal criteria for involuntary hospitalization, the provider may issue a “pick-up order”. This allows the police to involuntarily transport your family member to a hospital for evaluation. Please note: the legal criteria for issuing a pick up order are established by New York State law and decisions to issue such an order must be in accord with statutory criteria.
 
NY State's Assisted Outpatient Treatment Law (Kendra's Law) permits a judge to commit someone to hospital treatment if he or she refuses to follow a plan for outpatient mental health services. In that case, the family or friend of the patient would have to petition the court for priority treatment by applying to the county Office of Community Services' AOT coordinator (Sean Tuckey,518-386-2218)  
 
5. Assistance for children: Where a child with mental or emotional illness is involved, a procedure for getting assistance for that child through the publicly assisted system would flow through the Child and Youth Single Point of Access (SPOA) Coordinator, Robin Boyd at518-386-2218   
 
   .
6. Most housing services are through Mohawk Opportunities or Rehabilitation Support Services (RSS), Municipal Housing Authority or YMCA. Both Mohawk and RSS are licensed by the Office of Mental Health and are funded by Medicaid. They can accept private pay clients on a case by case basis. Please see residential services section for contact information. For group residence beds and both licensed and supported apartment beds you or your family member should speak with their clinician to apply for housing or case management services.
 
For federal HUD Section 8 rent vouchers and apartments in the housing complexes, apply directly to the Schenectady County Municipal Housing Authority. Some of this housing is set aside for elderly mentally ill people. For Section 8 rental assistance units outside Schenectady County, call 518-372-8845      .
 
For the Shelter Plus Care program for homeless mentally ill people and for YMCA supported housing you must be referred by one of several agencies serving the disabled. and by county DSS. For subsidized private rental housing (see Directory) you must have low or moderate income to qualify. Apply directly to the building complex.
 
7. Many patients or clients admitted to these programs have Medicaid or Medicaret cover hospital, clinic and continuing treatment expenses; and they have either Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) to pay living expenses in the housing programs. Other persons can be admitted to mental health services programs who have private health insurance coverage, managed care, or can pay privately and otherwise qualify. Ellis Hospital Mental Health Services offers financial assistance programs for those clients who do not have insurance.
 
8. To obtain a Medicaid card, apply to County Department of Social Services (DSS), 487 Nott Street,   518-388-4445  . You apply direct, in person. Call first, bring papers. If you are a nursing home patient, call518-388-4759   or518-388-4753 . See Directory for DSS phone number for HEAP (Home Energy Assistance Program, Food Stamps, Public Assistance, etc). Persons without food can access cash benefits from DSS and temporary Medicaid card for medicine, doctor visits and other health care. If you are approved for SSI (see below) you then receive Medicaid. Children are automatically on Medicaid if their parent qualifies.
 
9. To get on social security, specifically supplemental security insurance (SSI) and social security disability insurance (SSDI) and Medicare: apply directly to Social Security Office at 530 Franklin Street (518-382-1001) for an interview for eligibility determination. Hours are 9AM to 4PM weekdays. No form to fill out. You get a piece of paper when you check in. Bring proof of birth. If you are applying for SSDI, bring sufficient proof of work (pay stubs).
 
Different rules apply for eligibility of children and for elderly than for non-elderly adults. Currently there is a few months’ backlog before decision is made to accept someone. Then another 60 to 90 days to receive a check. You apply for Medicare Parts A and B here also if you are disabled or over 65 (not part D). You do not apply here for Medicaid.
 
10. For health insurance for low income disabled persons (besides Medicaid and Medicare):
 
1) Child Health Plus is overseen by NYS Department of Health and administered by private health insurance companies such as Fidelis Care, GHI or CDPHP in our area. Call the company direct.
 
2) Family Health Plus is Medicaid-type health insurance for adults, administered by NYS Department of Health. Call direct to1-877-934-7587.
 
3) “Healthy New York” is a low cost program NYS sponsors for small businesses so they can provide health insurance for their employees. Check with employer.
 
4) NYS Disability Insurance is provided to those who are working and become disabled. Form is filled out by medical provider and claim is filed with employer.
 
5) Medicaid Buy-in offers Medicaid coverage to people with disabilities who are working and earning more than allowable limits for regular Medicaid. Call Social Security Department or benefits counselor at1-888-224-3272 .
 
6) You can use the NYSARC Supplemental Needs Trust to qualify for Medicaid and eliminate the spend-down for persons who are elderly (65+), blind or disabled  (Call NYSARC  518-439-8323      ).
11. How to file for unemployment insurance – No office exists any longer in Schenectady – you can use NYS Labor Department's telephone claims center. Call 1-888-209-8124 to speak to a representative and file a claim for insurance. Or apply on the Labor Department’s Division of Employment internet site www.labor.state.ny.us You assign yourself a four-digit PIN number, file claim there. Once filed, you certify it and continue to call in weekly.
 
12. Where to find a Psychiatrist, Psychologist or Medical Doctor – if you do not belong to an HMO (health maintenance organization) or similar health plan, you do not attend the Ellis Mental Health Clinic or CDPC Franklin Street Clinic, and you are on low income, you may have difficulty finding a psychiatrist or psychologist in private practice. For a recommendation for a specific doctor, nurse practitioner or other mental health professional, you might ask a trusted friend or relative, called Medical Society of Schenectady
County  518-346-3300 or NAMI-Schenectady 518-377-2619 .
 
Very few psychiatrists and psychologists in private practice accept Medicaid as payment. General practitioners (MDs) including physicians on staff at medical/health agencies like Hometown Health Center can prescribe psychiatric medication and refer you to a psychiatrist at a mental health clinic for follow up. Psychologists do not prescribe medications. There are rosters of medical doctors on the internet (look up by name).
 
13. How to find a therapist (social work counselor)—If you think mental health treatment might be helpful to you, your child or other loved one, you may want to find a therapist and have a few meetings to learn more about ho treatment can work to address the problems you have. The next step is to find a therapist. You will want someone who is trained and experienced in dealing with the problems you are having, as well as someone with whom you feel comfortable and who has fees you can afford. People get recommendations from their doctor, a trusted friend, family members or a member of the clergy. Other people feel comfortable going to a therapist at the local community mental health clinic. Such clinics are licensed by NY State and require their staff to have the proper credentials.
 
14. Where to find an attorney – NAMI NYS 518-462-2000   has a list of attorneys for estates and trusts, elder law and disability law. NAMI Schenectady 518-377-2619 can refer you to local attorneys for defense in criminal cases. Or check State Bar Association. For legal representation in civil cases, see listings in Directory for Legal Aid Society, the Center for Community Justice and other agencies. In criminal cases, the court usually must assign a public defender in our county for an indigent defendant if no other legal representation is available. For legal assistance with social security applications and appeals, try Albany attorney Kristen King 518-456-3579 .
How does someone obtain information about domestic violence? Domestic violence is a crime. Information can be obtained from the NYS Office for the Prevention of Domestic Violence website at http://opdv.state.ny.us. The NY State Department of Probation and Correctional Alternatives has a project that includes probation officer training in response to domestic violence and it has a network of domestic violence liaisons from each county.
 
15. To get free and low cost medicines and medical care (other than through Medicaid and Medicare):  
1) try patient assistance programs of many of the drug companies for those who don’t have medical insurance. For example, Partnership for Prescription Assistance is a single point of access to more than 475 public and private patient assistance programs that could provide help with more than 2,500 medicines. Call 1-888-477-2669 .
2) Schenectady Free Clinic at 600 Franklin Street518-344-7067.
3) Bethesda House drug assistance program, 418 Liberty Street, has free medical clinic on site open Thursdays. 
4) City Mission of Schenectady has free medical care Wednesdays518-346-2275      .
5) Many physicians have free samples and will order free or discounted drugs for patients.
6) Canadian drugs are usually cheaper than American. See www.canadadrugs.com, a website for purchasing discount price Canadian drugs 1-800-226-3784
7) EPIC, NY State’s senior prescription plan, can be combined with Medicare Part D coverage to help save even more on medicine. 8) Medicare has a special benefit for seniors with limited incomes, called Extra Health at1-800-332-3742  .
16. Self help for mental health consumers – self-help groups of consumers who have a similar illness or diagnosis, or a common interest, are ephemeral (come together now and then but not for long). See Consumer clubs, self-help groups in the Directory. Also call Lynne Davidson of Ellis Peer Advocacy Program 518-374-2785, Mental Health Self-Help Clearinghouse
 
1-800-766-6177/span>; Collage Social Club518-374-9645,, Ellis Continuing Treatment 518-243-3360  or CDPC Community Support Center 518-374-3403.
 
17 Family Support – Groups serving families, such as NAMI (see internet site: namischenectady.org), regularly meet locally and have wider circles of support from statewide and national organizations plus newsletters, conferences, websites, and physician toll-free call numbers. State-level advocacy and organizational aid for families and consumers is available from NAMI-NYS (www.naminys.org) at & 518-462-2000 . NY Association of Psychiatric Rehabilitation Services (NYAPRS) at518-436-0008; Consumer Empowerment Center,518-434-1393  or Mental Health Association in NYS at  518-434-0439 . National NAMI website is www.nami.org .
18.span class="Apple-converted-space"> Complaints – where to call:& NYS Commission on Quality of Care:1-800-642-4143  (For problems concerning inpatient and outpatient treatment). NYS Office of Mental Health main hotline1-800-597-8481  . NYS Office of Mental Health Family Liaison518-474-4888 (assists families in advocating for loved ones in hospital or clinic settings.) NYS Office of Recipient Affairs/em>::518-473-6579 (Peer advocates assist consumers with problems with treatment.). Center for Medicare-Medicaid Services (CMS) 1-800-633-4273 (for issues with Medicare Part D drug plan.)
 
 

Appendix B

Right to An Appropriate Discharge Plan


 

Monday, 2 March 2013 at 20:30 EST, by SiteAdmin

For inpatients on a psychiatric unit getting ready to leave the hospital, the law requires a discharge plan, if done correctly, ensures that the person will receive the services needed upon return to the community. Section 29.15 of the Mental Hygiene Law spells out the step-by-step procedures that hospitals must follow to develop a proper discharge plan. Before discharge, the hospital must:
 
1.Prepare a written service plan, which includes:
 
 (1) a statement of the patient’s needs for housing, supervision, medication, psychiatric treatment and employment. This means that the hospital must determine what services are needed when the patient leaves the hospital, and
 
(2) an evaluation of needs and eligibility for benefits. This means that the hospital must try to determine the public benefits for which the patient is eligible.
 
2.Help with the application for benefits, including Public Assistance, Medicaid, food stamps, and SSI/SSDI, before discharge.
 
3.Actually discharge the patient in accordance with the plan. This means that the hospital must provide the link to services that have been identified in the written service plan. For example, if the plan states a need for supportive housing, mental health treatment and public benefits, the hospital must coordinate these services for the patient before release from the hospital. Also, a hospital cannot discharge the patient to the street, a shelter, flop house, or a facility without a current and valid license. It should be noted that all patients in need of services have the right to choose whether or not they want to take advantage of their discharge planning rights. No patient can be forced to accept discharge planning services.
 
4.In addition, the law states that the following people have the right to participate actively in developing the discharge plan: the patient, an authorized representative that the patient has chosen, and – at the patient’s request – a significant individual such as a friend, family member or other outside advocate.
 

Appendix C

How to Help When A Person with Mental Illness is Arrested


 
To find status of arrestee, what to expect of jail and court procedures, and getting medicine to the person in jail, contact Kristen Wagner, Ellis Hospital Mental Health worker at (cell)518-858-6319 .
Most arrests happen spontaneously if a police officer observes a crime or is told a crime has occurred. Once a person is arrested and is taken into custody the police have the right to search the person and if drugs or weapons are found, those charges are added to the original ones. At the police station, a person in custody may be given an appearance ticket to come back at another time and is released, or he is kept in custody.
 
From there he is usually taken from the local police station (city, town or village) directly to a judge for arraignment to hear the charges and for the judge to decide to release the person, set bail or send him to jail. He can be held in the local police lockup until arraignment, often overnight. If you can find where the person is, you should get him an attorney before arraignment, or a public defender may appear and be assigned to him. The judge can also adjourn the case in contemplation of dismissal (ACD) or release the person in his own recognizance.
 
If it is a minor crime, the defendant may plead guilty and be sentenced to community service, pay a fine or be sent to jail. Even after your relative is arrested, it’s not too late to do something. Police have discretion as to who to arrest, who to hospitalize and who to ignore. If someone you care about is in a situation where they could be arrested and you are there, ask the police not to arrest the person. You might say “He just needs his medication. I’ll come with him to the hospital”.
 
Even after his arrest, you may be able to get the person in effect, “un-arrested”. Find out where the person is being held and go there, or call if you can’t go. Talk to the police and ask if they can drop the charges, or if not, at least let the person out to come back to court later. Offer to take as much responsibility for the person as you feel comfortable doing. If you can promise to bring the person to court, the police may release someone who otherwise would have “gone through the system”.
 
If you are present when a person is being arrested or when he is in custody, the most helpful thing you can do is tell the person not to talk to the police. What he says can be used against him in court. During the first 24 hours after the person was arrested, you will probably not be able to do anything about getting the person medications. But by going to the arraignment you may be able to help someone avoid going to jail or even help get the charges lowered or dismissed. By being there, you demonstrate to the judge this defendant has ties to the community and people who will help him return to court. It’s also a chance to give the defense attorney information about the person’s mental health situation.
 
Call the police station where the person was arrested to find when and where the arraignment is. You may need to speak to the clerk at the courthouse to get a sense of when the person will be arraigned. If you can’t afford an attorney a person charged with a crime has the right to a defense attorney even if you can’t afford one. For help obtaining an attorney and individual advocacy issues, call Bob Corliss, Mental Health Association of NYS 434-0439 ext. 221.
 
Much of the above is from a 35-page booklet “How to Help When a Person with Mental Illness is Arrested”. (Call NAMI NYS for a copy at 518-462-2000. There is also information on probation and parole, the meaning of an arrest warrant and how to “clear up a warrant” for the person’s arrest for violation of probation. NAMI also has information on jail diversion, alternative treatment courts; booklet for professionals “Working with People with Mental Illness Involved in the Criminal Justice System” & a forensic resource list. Pertinent phone numbers: sheriff’s office at jail 518-388-4300 , District Attorney Robert Carney518-388-4364, Public Defender Mark Caruso 518-386-2266, Probation Director Mary Lolik 518-388-4330  and Ellis Forensic Social Worker Kris