If you or your family needs mental health services, we make it easy to get services from the provider of your
choice.

We are as close as any telephone

• Call 1-800-804-5008. You can call 24 hours a day, 7 days a week. You can talk to a mental health counselor who will help you find a provider who meets your needs; OR
  
  
• Call or visit the community mental health center serving your county. The mental health centers are listed in Appendix A. Also, you can call 1-800-804-5008 for the number of your mental health center;  OR
  
  
• Use this website. It gives you all of the information in our member handbook and much more. It is a good place to find information about mental health and resources in your community;  OR 
  
  
• Find a provider

You may choose to get your services at one of our community mental health centers or with one of our independent providers. You have the right to choose. You may also ask to have a provider added to our network. If you need the care of a specialist, we will refer you to one. 

Our provider list is easy to get. You may ask for this list at any time. It gives you the provider’s name, address and languages other than English that the provider speaks. Call us at 1-800-804-5040 during business hours to ask for this list. Or visit Referral Connect at (link to ReferralConnect). Our providers do not have incentive plans. 

There is no charge to you for any services covered by your Medicaid Mental Health Plan. There are NO co-pays. If you get a bill for any mental health services you get, contact us at: 

Colorado Health Partnerships
 Office of Member and Family Affairs
7150 Campus Drive, Suite 300
Colorado Springs, CO 80920
1-800-804-5040

Hours of Operation
Our business offices are open from 8:00 a.m. to 5:00 p.m. Monday through Friday. You can talk to someone on our Access to Care Line 24 hours a day, 7 days a week by calling 1-800-804-5008.

Location of Services
You may have already received a list of mental health provider’s from us. You can also find CHP mental health centers in the Community Mental Health Centers List (link to 7.2.1.8 Community Mental Health Centers). The business offices at the mental health centers are open from 8:30 a.m. to 5:00 p.m. Monday – Friday. Call them to find out when they have clinical hours. Some offer appointments in the evening and on weekends. The phone numbers are listed in the Community Mental Health Centers List (link to 7.2.1.8 Community Mental Health Centers)  

When Will I be Seen?
As a Medicaid member, you have the right to get mental health services in a timely manner.

• When you call to make a first or routine care appointment, we will offer you an appointment within 7 days.
• If you call us about an urgent mental health problem, we will see you within 24 hours.
• If you are calling with a mental health emergency, we will see you within one hour if you live in a city. If you live in a rural area, we will see you within two hours.

When you call to make a first appointment, it is important to tell us if you have a special need. Some of our members may need special help to get the most from their mental health services. If you have a disability and need an accommodation, please let us know when you call for an appointment. Also let us know if you need an interpreter for a non-English language or someone who knows sign language.

What can I expect at my first appointment?

When you begin mental health treatment, we will ask questions to help us understand what you need. We will ask about your background and family history. We will talk with you about your strengths, your problems and any mental health symptoms you have. Because your mental and physical health affect one another, it is important that you tell us about any medical care you are getting and any medications you are taking. We will use all that you tell us to decide what kinds of services or medication will help you get better. You are a partner in these decisions.

You will get a Care Coordinator. Your Care Coordinator will:

• Be in charge of your records and your treatment.
• Help you create your service (treatment) plan.
• Ask you to sign releases of information for other providers and your supporters. This is so that we can coordinate your mental health and other health services.
• Help you identify any special needs you may have.
• Work with other community agencies to help make sure that your other needs (such as medical and housing) are met.
• Provide follow-up and help in a crisis.

 What if I miss an appointment?
Modern life is busy. We understand that people sometimes can’t make it to their scheduled appointment. If you have to miss an appointment, we ask that you call at least 24 hours before your scheduled appointment. This way, your provider can make another appointment for you. It also gives other people who need an appointment the chance to get one. If you keep missing appointments, we may think you do not want to come. We will call you to ask why. If you miss more than three (3) appointments without calling or returning our calls, we may ask you to see a different provider.

Who will be my Care Coordinator?
A Care Coordinator can be your therapist or case manager. He or she is your primary mental health provider. We want you to get the best possible care. Only the most skilled providers are included in our network. You have the right to select a provider from our network, but we will try to match the provider’s skills with your needs. You may ask for an out of network provider, or ask to have a provider added to the network. If you choose to see a provider who is not in our network, and don’t get approval to see the provider, you may have to pay for your care.

What is a service plan?
This is a plan that you help develop that will guide your treatment. It takes into account your goals in life as well as in treatment. It may include wellness activities, housing, jobs, education and relationships you want. As a partner in your care, you need to be involved in writing your service plan. If you want, you can include other people who can advocate for and support you when making your plan.

What Mental Health Services can I get?

Your Medicaid Mental Health Plan Covered Benefits

Case Management Services	These are services you get in the community. They help you stay in the community. They include service planning, outreach, referral and coordination of services. Routine case management is part of the services provided by your mental health outpatient Care Coordinator.
Emergency Care	Emergency care is the treatment of a mental health condition that is life threatening. It is life threatening to the person who is having the crisis. Or, another person may think it is life threatening to you.
Inpatient Hospital	Inpatient services are those mental health services that need to be given in a hospital. Your plan benefit allows up to 45 inpatient hospital days per year. However, youth under age 21 may qualify for more hospital days if medically necessary. This is through the Early Periodic Screening, Diagnosis and Treatment Program (EPSDT),
Medication Management	This is when a doctor, or other licensed prescriber, prescribes and monitors your psychiatric medications.
Outpatient Treatment	These are services you get in an office or other place in the community. Services include individual, brief, family and group therapy. Your Medicaid plan benefit allows up to 35 individual or brief sessions per year. Through the EPSDT, youth under age 21 may qualify for more outpatient treatment visits if medically necessary.
Psychosocial Rehabilitation	Psychosocial rehabilitation programs help people with serious mental illness. They teach people the skills they need to live in the community.
Residential Treatment	A residential treatment program is a 24-hour living situation. It provides care when a person does not need to be in the hospital, but still needs help and structure 24-hours a day. Residential treatment can be for adults or children.
School-Based Services	School-based services are for children and youth with special mental health care needs. They are provided in the school setting. Services may include smaller classrooms, specially trained staff, counseling and other services to help the child succeed.

Other Services
The following services may be offered in your community. To learn more, call your mental health center or CHP. The mental health center numbers are listed in the Community Mental Health Centers List (link to 7.2.1.8 Community Mental Health Centers)  

• Vocational and employment services;
• Home-based services for children and adolescents;
• Intensive case management;
• Respite services;
• Drop-in centers;
• Clubhouses;    
• Peer services and support services;
• Peer mentoring for children and adolescents;
• Assertive community treatment programs;
• Warm  (telephone support) lines;
• Special services for adoption issues;
• Early childhood intervention services;
• Family support, education and training services;
• Multi-systemic therapy;
• Prevention services and early intervention activities;
• Recovery services;
• Supported employment.

How will I know if there are changes in my Mental Health Coverage or Benefits?

CHP gives you this information in several ways:

• We will give you written notice of any major change at least 30 days before the date of that change.
• We will notify you of your right to ask for information about Medicaid mental health benefits and services at least once a year.
• If there are changes with the person or the location where you get your mental health services, we will contact you by mail. We will try to let you know at least 15 days ahead.
• We will have information on changes at our community mental health center centers.
• We will have information on changes on our website.

You may also call the CHP Office of Member and Family Affairs at 1-800-804-5040 to ask for a copy of this information at any time.

How do you make decisions about my care?

Medical Necessity
We consider medical necessity when working with you to come up with a service plan. The state defines a service as medically necessary if it:

• Is reasonably needed to treat the problem,
• Is reasonably needed to improve, make stable, or keep your conditions from getting worse,
• Is given in the most appropriate, least restrictive, and safe setting, and
• Cannot be stopped without it having a bad effect on your health or the quality of your care. 

It is important that you get medically necessary services when you need them.

Clinical Guidelines
Our licensed clinicians also use clinical guidelines to help us make decisions about care that is right for you. Our clinical guidelines are based on the definition of medical necessity above. Providers, members and family members help us develop these guidelines. We do not deny services based on moral or religious objections.

If you would like a copy of our clinical guidelines, please click (link to 6.4 clinical guidelines) or call us at 1-800-804-5040.

Least Restrictive Setting
State and federal Medicaid rules require that we provide services in the least restrictive setting that will meet your needs. This means that care should be provided in the community whenever possible.

What if I have a disability, special need, or need help speaking or understanding English?

When you call to make a first appointment, please let us know of any special needs you may have. For example, you may have a disability and need an accommodation. We will use AT&T Language Line telephone interpreters if we do not speak your language. Or we will use Relay Colorado or a TTY line if you are Deaf or hard of hearing.    

If you do not speak English, we will try to find a provider who speaks your native language. If you are Deaf, we will try to find a provider who signs. If none are available, we will provide an interpreter. We never ask family or friends to interpret-unless that is your choice.
Our written materials are available in Spanish. If you speak a language other than English or Spanish, we will arrange to have an interpreter read our materials to you. We also have materials on audiotape or in large print.
There is no fee for any of these services. Please call us to ask for any of these services or materials at 1-800-804-5040.

New Treatment Procedures
Sometimes you find out about a new treatment or medication and would to learn more about how it might work for you. We keep up with new treatment and new medications. You have the right to ask that we review any new treatment or medications that you think might help you.