| I. PURPOSE
| | The purpose of this policy is to establish policy and procedures regarding access to care for initial and subsequent requests for services, including screening/triage requirements, and time frames for appointments.
Contracted agencies shall develop an internal policy and associated procedures that are consistent with their organizational practices and meet the requirements set forth in this policy.
| II. DEFINITIONS Appointment: A time slot allotted for a service including emergency/non-scheduled response time. Authorized Mental Health Discipline (AMHD): Eligible disciplines that may provide direction regarding the care of clients in the Los Angeles County Department of Mental Health (LACDMH) System of Care. Eligible disciplines are: - Licensed Psychiatrist/Physician (MD/DO), Certified Nurse Practitioner (NP), registered Clinical Nurse Specialist (CNS), Registered Nurse (RN);
- Licensed or waivered Psychologist (PhD/PsyD);
- Licensed Clinical Social Worker (LCSW) or registered Masters in Social Work (Associate Clinical Social Worker - ASW) or out-of-state licensed-ready waivered Masters in Social Work;
- Licensed Marriage and Family Therapist (LMFT) or registered Marriage and Family Therapist (Associate Marriage and Family Therapist) or out-of-state licensed-ready waivered Marriage and Family Therapist; and Licensed Professional Clinical Counselor (LPCC) or registered Professional Clinical Counselor (PCC); and
- Occupational Therapist (OT).
Emergent Service: Service needed for potential client/client who may present a current danger to self or others or is immediately unable to provide for or utilize food, clothing, or shelter. Expedited Service: Service needed prior to the next available routine appointment. Expedited services are not required to be provided on the same day as the request. Behavioral Health Crisis: Any event or situation associated with an actual or potential disruption of stability and safety as a result of behavioral health issues or conditions. Mobile Crisis Team: Field Intervention Teams (FIT), comprised of Psychiatric Mobile Response Teams (PMRT), Mobile Crisis Outreach Teams (MCOT), and Therapeutic Transportation teams that meet Department of Health Care Services (DHCS) requirements per Behavioral Health Information Notice (BHIN) 23-025, including dispatch from the DMH ACCESS Center and availability 24/7 . Potential Client: An individual who is seeking, or for whom someone else is seeking services. Primary Contact: An individual practitioner assigned to a client at a provider and designated for care coordination. Routine Service: Service that does not necessitate emergency, behavioral health crisis, urgent, or expedited services and scheduled for the first available appointment within the prescribed time frame. Screening: A brief interaction by any staff to determine the reason for presentation and service needs. Urgent Service: Service needed for potential client/client who may present with a condition or situation that, if not addressed, would be highly likely to result in an immediate emergency condition. | III. POLICY All requests for service whether the request is made by the client, potential client, or someone on their behalf via telephone, walk-in, or in writing (electronic or hard copy) shall be screened to determine whether the need for service is a behavioral health crisis, emergent, urgent, expedited, or routine. If screening indicates the client or potential client is in distress and/or they have run out of medications they should be triaged to determine the urgency to be seen. - If the request is an initial request for services, it must also be handled in accord with DMH Policy 302.14.
- If the client is determined to be an active client, they shall be referred to their primary contact or other available party who shall determine the need for services.
All missed or canceled appointments shall be screened at the point of non-attendance or cancellation to determine if the appointment needs to be re-scheduled and, if so, how soon the client or potential client needs to be seen. All appointments shall be offered within the time frames identified in the Procedures section. - If multiple time frame requirements are identified based on screening and/or triage (e.g., discharge from institution, about to run out of medications, has run out of medications), the provider must adhere to the shortest required time frame.
- If a provider is unable to meet a time frame requirement and it is determined that waiting would be detrimental to the health of the client, the potential client/client shall be referred to another provider, Service Area Navigator, or Psychiatric Urgent Care Center as appropriate.
All information related to determination of when a client needs to be seen, including information obtained through the screening process, shall be created and maintained in accordance with DMH Policies 300.06, 401.01, and 401.02. Offered provider sites shall be no more than 30 minutes (time) or 15 miles (distance) from a potential client/client’s residence to the offered provider site, regardless of Service Area. Offered provider sites may be outside the time or distance standards if: . - The provider travels to the client to deliver services.
- It is the client’s preference to receive services from a clinic outside the time/distance standards
Offered appointment times and service location shall be based upon client preference and availability of the necessary service provider. The location where a client travels to receive a service, must meet the time and distance standards whether service are delivered in person or via telehealth. - Telehealth services may be used as long as the physical location where the client receives the telehealth services (eg clinic kiosk) is within the time and distance standards to the potential client/client’s residence.
| | | | V. AUTHORITIES
| | | | VI. ATTACHMENT
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