Appendix A

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 – 797 Broadway, Suite 304, Schenectady; 518-386-2218.

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 eligibility for specialized licensed mental health housing, case management or ACT services, contact your family member’s clinical provider. If you have general questions regarding the SPOA process, contact the SPOA desk, Schenectady County Office of Community Services located at 797 Broadway, Suite 304, Schenectady; 518-386-2218.

The YMCA “Commons” – 845 Broadway, Schenectady – offers some specialized housing for men with a severe mental illness. Contact  518-374-9136  for more information.

Other options include apartments administered by the Schenectady Municipal Housing Authority (SMHA) – 375 Broadway, Schenectady – 518-386-7000. 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 because the waiting list for a Section 8 voucher is generally long, Section 8 housing is normally not available if your family member is in immediate need of housing assistance.

2. For mental health clinic or continuing treatment services call Ellis Mental Health Clinic now located at 1023 State Street, Schenectady. Phone 518-243-3300  for an intake appointment with a counselor and/or psychiatrist, or have your doctor make this referral. Child and adolescent mental health services can be reached at 518-382-2290.

Individuals in managed care plans may need a referral from either the plan or from a primary care physician. Patients who wish to receive services from the CDPC Community Support Clinic can contact them at 738 State Street, Schenectady 12307 – 518-374-3403.

If you believe the condition of a person in treatment 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 can be either voluntary or involuntary. Crisis services at Ellis Hospital may be accessed by calling  518-243-4000. If your family member needs and wants a crisis evaluation, he or she should go to Ellis Hospital’s emergency room. If a doctor determines he or she needs inpatient care, and your family member agrees to admission, he or she will be voluntarily admitted for inpatient care.

If someone 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 law’s provisions.  Please note: All decisions on whether inpatient services are appropriate as well as whether a patient should be voluntarily or involuntarily admitted are made by a physician.

4. Police assistance:  Important: If your loved one poses an immediate threat 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 say 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 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 involvement. Ideally, family members or friends will be able to influence the decision in the direction of getting medical treatment rather than incarceration, but this is not always possible.

If you do not believe your loved one poses an immediate threat to harm self or others, contact Ellis Crisis Services, 518-243-4000, to discuss your concerns.

You may contact your loved one’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” that allows the police to involuntarily transport him or her 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 specific 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’ ACT coordinator at 518-386-2218.

5. Assistance for children: Getting help for a child with mental or emotional illness through public assistance flows through the Child and Youth Single Point of Access (SPOA) Coordinator at the Office of Community Services at 518-386-2218.

6. Housing services can be obtained through Mohawk Opportunities at 518-374-8424, or Rehabilitation Support Services (RSS) at 518-462-1094; phone numbers for the Schenectady Municipal Housing Authority and the YMCA are found in section 1 above. 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. To apply for housing or case management at group residences or at licensed and supported apartments, you or your family member should speak with his or her clinician.

For federal HUD Section 8 rent vouchers and apartments in the municipal housing complexes, apply directly to the Schenectady County Municipal Housing Authority. Some of this housing is set aside for elderly mentally ill people.

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 Schenectady County Department of Social Services. For subsidized private rental housing (see our Directory) you must have low or moderate income to qualify, and should apply directly to the facility’s rental office.

7. Many patients or clients have Medicaid and/or Medicare to cover hospital, clinic and continuing treatment expenses; and either Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) to pay for living expenses in the housing programs. Some persons obtaining mental health services may have private health insurance coverage, managed care, or can pay privately. Ellis Hospital Mental Health Services offers financial assistance programs for those clients who do not have health insurance coverage.

8. To obtain a Medicaid card, apply to the County Department of Social Services (DSS), 797 Broadway, Schenectady,   518-388-4470.   Apply in person, but call first and bring papers you are asked to submit. See Directory for the DSS phone number for the Home Energy Assistance Program (HEAP), Food Stamps (SNAP) and Public Assistance, etc. Persons without food can access cash benefits from DSS and a temporary Medicaid card for medicine, doctor visits and other health care. Those approved for SSI (see below) will receive Medicaid. Children are automatically on Medicaid if their parent qualifies.

9. To get on Social Security, specifically Supplemental Security Insurance (SSI), Social Security Disability Insurance (SSDI) and Medicare: apply through the Social Security Office at 1 Broadway Center, 8th floor, Schenectady 800-772-1213 or 866-964-1296 and request an interview for eligibility determination. Office hours are 9AM to 4PM weekday except for Wednesdays when the Social Security Office closes at noon. When you check in you will receive a piece of paper. Bring a valid proof of birth. For SSDI applications, bring sufficient proof of work (paystubs).

A different set of rules apply for the eligibility of children and the elderly than for non-elderly adults. There may be a few months’ backlog before a decision to accept someone is made, and then it may take another 60 to 90 days to receive a check. Applications for Medicare Parts A and B can be made there also if you are disabled or over 65 (not part D). (Medicaid is not the same as Medicare. It is obtained through DSS.)

10. Health insurance for low income disabled persons (besides Medicaid and Medicare):

(1)  Child Health Plus is overseen by the NYS Department of Health and is administered in our area by private health insurance companies such as Fidelis Care, GHI or CDPHP. Call the health insurance company directly or call NY State of Health Marketplace at 1-855-355-5777.
(2)  Family Health Plus is a Medicaid-type health insurance for adults, administered by the NYS Department of Health. Call directly toll-free: 877-934-7587.
(3)  “Healthy New York” is a low cost program New York State sponsors for small businesses so they can provide health insurance for their employees. Check with your employer or the NY State of Health Marketplace (see 1 above).
(4) ) NYS Disability Insurance is provided to those who are working and become disabled. A form is filled out by ones medical provider and then the claim is filed with ones employer. Dial 1-800-353-3092 for further information.
(5)  Medicaid Buy-In offers Medicaid coverage to people with disabilities who are working and earning more than allowable limits for regular Medicaid. Call DSS at 518-388-4470
(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: A NYS Labor Office no longer exists in Schenectady. Call the NYS Labor Department’s telephone claims center at: 1-888-209-8124  and ask 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.ny.gov  At the website you pick your own four-digit PIN number and file your claim on-line. Once filed, you certify it and continue to report in weekly.

12. Where to find a Psychiatrist, Psychologist or Medical Doctor – NAMI recommends that you check with other families who have relatives with mental illness for recommendations of particular psychiatrists or therapists that they have had good experiences with. One’s doctor, a trusted friend, or a member of the clergy may suggest someone they know. It may prove difficult to find a psychiatrist or psychologist in private practice simply because not as many medical students are electing to go into psychiatry. You can check with the Medical Society of Schenectady County 518-346-3300 or NAMI at affiliate or state levels for names and numbers.

Unfortunately, few psychiatrists and psychologists in private practice accept Medicaid or Medicare 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. Medical doctors may be found on the Internet.

13. Next steps in the process: For many, once a crisis has been managed well enough that a patient can be discharged from a hospital, the primary source of care for mental disorders is provided in an outpatient mental health clinic or office where a practitioner, possibly a psychiatric social worker, meets with the patient, providing direction for his or her treatment and recovery. It may be helpful for your loved one to meet with him or her several times before making the decision that a particular practitioner is or is not going to work out. A good choice will be someone with whom one feels comfortable, someone who makes a special effort to communicate with the family, enlisting its members as part of the treatment, when indicated. You want someone who recognizes the illness is a no-fault brain disease. He or she should be innovative enough to try different ways to engage with a patient who may not believe he or she is ill. Does this practitioner take seriously information communicated by the family about what they see going on with their loved one? Does he or she try to schedule visits less often in order to match a family’s ability to pay what insurance does not, i.e., is he or she flexible, and more concerned with outcomes than about maximizing his or her own income? When considering where to receive care, keep in mind that community mental health clinics are licensed by New York State, and these clinics require that their staff 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. Roy of NAMI Schenectady (518-377-2619) may suggest local attorneys for defense in criminal cases. Or check with the State Bar Association. For legal representation in civil cases, see listings in this site’s Directory for the Legal Aid Society, the Center for Community Justice and other agencies. In criminal cases, when the defendant is indigent, the court will assign a public defender. For legal assistance with social security applications and appeals, try Albany attorney Kristen King at 518-456-3579.

How does someone obtain help if dealing with 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.ny.gov. The NY State Department of Probation and Correctional Alternatives has a project that includes probation officers training in response to domestic violence and it has a network of domestic violence liaisons in each county. DSS and Child Protective Services can help. The Schenectady County YWCA can also help at 518-374-3394.

15. To get free and low cost medicines and medical care (other than through Medicaid and Medicare):

(1) Those who lack medical insurance, especially drug coverage, can look into patient assistance programs set up by a number of the drug companies. For example, Partnership for Prescription Assistance is a single point of access to more than 475 public and private patient assistance programs that may provide help in paying for more than 2,500 medicines. Call 1-888-477-2669.
(2) Bethesda House, now located at 834 State Street, Schenectady, 12307, has held a free medical clinic on site in the past. Their 2018 schedule lists a Wednesday blood pressure clinic held on site from 1:00-2:30 pm.
(3) City Mission of Schenectady offers free medical care on Tuesday evenings at 6pm at their Dining Center at 512 Smith Street, Schenectady NY 12305 518-346-2275.
(4) Many physicians get free medication samples and will order free or discounted drugs for patients.
(5) Canadian drugs are usually cheaper than American. See www.canadadrugs.com, a website for purchasing discount priced Canadian drugs 1-800-226-3784.
(6) EPIC (Elderly Pharmaceutical Insurange Program), New York State’s senior prescription plan, can be combined with Medicare Part D coverage to help save even more on medicine. EPIC has a toll-free Helpline available from 8:30AM to 5:00PM, Monday through Friday. Call 1-800-332-3742.
(7) Medicare has a special benefit for seniors with limited incomes, called Extra Health. For information call 1-800-772-1213 or general number 1-800-MEDICARE.

16. Self help for people in recovery  – self-help groups of individuals who are being treated for similar brain disorders or diagnoses, or who have other common concerns, may form clubs or associations for support and friendship. See Consumer clubs and self-help groups in the  Directory accompanying this site.  Information may also be obtained from Lynne Davidson of the Ellis Peer Advocacy Program at 518-374-2785; Mental Health Self-Help Clearinghouse at 1-800-553-4539; Ellis Continuing Day Treatment at 518-243-3300  or CDPC Community Support Center, 518-374-3403.

17. Family Support – Groups serving families, such as those recommended by NAMI, the National Alliance on Mental Illness, meet locally and offer even wider circles of support through their statewide and national organizations plus newsletters, conferences, websites, and toll-free call numbers. NAMI’s affiliate group in Schenectady recommends a Wednesday night support group meeting in Schenectady at Ellis Hospital in classroom B-3 at 6:00 pm, and a CDPC support group meeting Tuesday nights at 5:00 pm at CDPC, 75 New Scotland Avenue, Albany. State-level advocacy and organizational aid for families and consumers is available from NAMI-NYS (www.naminys.org)   518-462-2000;  NY Association of Psychiatric Rehabilitation Services (NYAPRS) at 518-436-0008; The Mental Health Empowerment Project, Inc. at 3 Atrium Drive, Suite #205, Albany at 518-434-1393; or Mental Health Association in NYS (MHANYS) at 518-434-0439 or 1-800-766-6177, and ask for re-entry hotline, M-F 9am-5pm.  The National NAMI website is www.nami.org.

18. Complaints –  Where to call: NYS Commission on Quality of Care for the Mentally Disabled: 1-800-642-4143  (For problems concerning inpatient and outpatient treatment.  NYS Office of Mental Health main customer relations number 1-800-597-8481  .  NYS Office of Mental Health Family Liaison 518-474-4888 (assists families in advocating for loved ones in hospital or clinic settings);  The Justice Center for the Protection of People with Special Needs, at 1-855-373-2122; NYS Office of Recipient Affairs:518-473-6579  (Peer advocates assist people in recovery with problems with treatment).  Center for Medicare-Medicaid Services (CMS)  1-800-633-4273 (for issues with Medicare Part D drug plan.)