Behavioral Health

Members receive behavioral health coverage through Mercy Care Department of Child Safety Comprehensive Health Plan.  

We’re here to help you and the children in your care. Our behavioral health services are designed to meet the needs of children and their families. We want to help the child and the whole family thrive. We believe that treating the whole child is one of the keys to achieving that goal. Mercy Care DCS CHP allows you and the member to choose  the child’s health care providers. We work with you and the child to find someone who fits the child’s health and wellness goals.  

Being removed from their home and placed in foster care is difficult and can be a traumatic experience for any child. Many children are placed in foster care due to some form of serious abuse or neglect. Research tells us that children in foster care often have emotional, behavioral or developmental problems. Physical health problems are also common. These problems and behaviors can appear suddenly or occur over time. If you notice a child in your care showing problem behaviors, he or she may need professional behavioral health support. It’s important to report any of these behaviors to the behavioral health provider and the DCS Specialist. 

Children suffering from traumatic stress symptoms generally have difficulty regulating their behaviors and emotions. They may be clingy and fearful of new situations, easily frightened, difficult to console, and/or aggressive and impulsive. They may also have difficulty sleeping and show regression in functioning and behavior. In regard to forming healthy attachments, traumatized children feel that the world is uncertain and unpredictable. Their relationships can be characterized by problems with boundaries as well as distrust and suspiciousness. As a result, children that have experienced trauma can become socially isolated and have difficulty relating to and empathizing with others. 

Navigating the behavioral health system 

Behavioral health services are always recommended for children placed in out-of-home care to address their behavioral issues. This is especially important for children under six years of age. It is best practice to have a behavioral health medical professional assess, evaluate, and monitor the unique behavioral health needs of children placed in out-of-home care. 

Behavioral Health: Integrated Rapid Response Assessment and on-going Behavioral Health Care 

All Mercy Care DCS CHP members have experienced trauma and should receive an Integrated Rapid Response Assessment from a behavioral health provider within 72 hours of removal and placement into out-of-home care. This assessment evaluates the member for any acute behavioral health or physical health needs they may have and supports the caregiver to address those needs. The provider assists with selecting a PCP and arranging an initial appointment. The provider will make sure that there is follow up by an ongoing behavioral health team to support the member and out-of-home caregiver.  

Foster Care Line 

If a behavioral health provider has not called you to make an appointment to arrange for an Integrated Rapid Response service within 24 hours after the member enters out-of-home care, call the Crisis Response Network Foster Care Line at 602-633-0763. 

All Mercy Care DCS CHP members must receive Behavioral Health services through an assigned behavioral health clinic.  Mercy Care DCS CHP requests that the appointment with the Integrated Rapid Response Team be arranged and ongoing Behavioral Health services occur within the timeframes listed below.  

Behavioral health appointments for persons in legal custody of the Department of Child Safety (DCS) and adopted children: 

  • Integrated Rapid Response Assessment (IRRA) – To be completed no later than 72 hours after notification by DCS that a child has been removed from their home 
  • Initial assessment – within seven calendar days after referral or request for behavioral health services (unless completed at the IRRA) 
  • Initial appointment – within time frames indicated by clinical need, but no later than 21 calendar days after the initial assessment/intake  
  • Ongoing behavioral health services – within the time frames according to the needs of the child, but no longer than 21 calendar days from the identification of need   

If clinically necessary services aren’t provided within 21 calendar days after intake assessment, the out-of-home caregiver (e.g., foster parent, kinship or group home) should call Mercy Care DCS CHP Member Services at 602-212-4983 or 1-833-711-0776 (TTY/TDD 711). Or, you can email the Mercy Care Single Point of Contact at DCS@mercycareaz.org. You should also reach out to the AHCCCS Clinical Resolution Unit line at 602-364-4558 or dcs@azhcccs.gov. The caregiver may then call any AHCCCS-registered providers directly, whether or not they are a part of the Mercy Care DCS CHP provider network, to schedule an appointment. 

You can find information about Behavioral Health services and more contacts on the AHCCCS website at  

www.azahcccs.gov/Members/AlreadyCovered/MemberResources/Foster/

 

During the Integrated Rapid Response Assessment, the clinician will assist in connecting the member to a Primary Care Physician, Assigned Behavioral Health Clinic or an Integrated Health Home.  After the child in your care becomes connected to a Behavioral Health Home, you will develop a “team” to help you identify the child’s behavioral health needs and get behavioral health services. We call these clinical teams, more specifically Child and Family Teams.  

 

You can choose a behavioral health clinic. Mercy Care DCS CHP can also assign you to a clinic. The clinic is where the child receives primary outpatient mental health services. Some clinics also offer physical health care. At the initial appointment, you can work with the DCS specialist to help determine who you want on the child’s clinical team. The team will work with the child on his or her goals. They will provide ongoing assessment and service planning. The members of the team will depend on the behavioral health professionals working with the child. Teams can include family members, guardians, friends, clergy and other supportive people from the community. Many times, the assessment that’s done at the first appointment won’t be complete. You’ll be working with members of the child’s team to continue that assessment process. This allows the child and the child’s team to always review progress and needs so that they get the best care. The treatment plan, also called an Individual Service Plan (ISP), should include all the services that the child needs, such as housing, support services, counseling, and transportation. The team should update the plan at least once a year, according to the child’s needs.  

 

The Child and Family Team (CFT) is a defined group of people. It includes, at a minimum, the child, DCS Specialist and his/her caregiver, a behavioral health representative and any individuals important in the child’s life identified and invited to participate by the child and family. This may include, for example, teachers, extended family members, friends, family support partners, health care providers, coaches, community resource providers, representatives from religious affiliations. It can also include representatives from other service systems like Juvenile Probation or Division of Developmental Disabilities (DDD). The size, scope and intensity of involvement of the team members are determined by the goal established for the child, the needs of the family in providing for the child and the resources needed to develop an effective service plan. People can join or leave the team, as needed, to make sure the child gets the best care. 

Mercy Care DCS CHP members are eligible for behavioral health services, which include drug and alcohol abuse services. Mercy Care DCS CHP Member ID cards have a phone number to access behavioral health and substance use services. 

Research on resilience in children demonstrates that an essential support needed for children to develop self‑care skills and confidence is the reliable presence of a caring, and protective parent/caregiver who can help shield children against difficult experiences. They can be a consistent resource for children in their care, encouraging them to talk about the experiences. And they can provide reassurance to the children that the adults in their life are working to keep them safe. 

Behavioral health services include, but are not limited to: 

  • Behavior management (behavioral health personal assistance, family support, home care training, self-help, peer support) 
  • Behavioral health case management services (limited) 
  • Behavioral health nursing services 
  • Behavioral health residential facilities/BHRFs (previously called Therapeutic Group Homes or TGHs) 
  • Behavior health therapeutic home care services  therapeutic foster care 
  • Emergency behavioral health care 
  • Emergency and non-emergency transportation 
  • Evaluation and assessment 
  • Individual, group, and family therapy and counseling 
  • Inpatient hospital services 
  • Non-hospital inpatient psychiatric facilities (Behavioral Health Inpatient Facilities/BHIFs previously called residential treatment centers or RTCs) 
  • Laboratory and radiology services for psychotropic medication regulation and diagnosis 
  • Opioid agonist treatment 
  • Psychosocial rehabilitation (living skills training, health promotion, supportive employment services) 
  • Psychotropic medication, adjustment and monitoring 
  • Respite care 
  • Substance use services  
  • Behavioral health screening 

The child’s PCP may be able to help if the child has depression, anxiety, attention deficit hyperactivity disorder (ADHD), or opioid use concerns. PCPs may give the child medicine, watch how the medicine is working and order different tests in order to determine the best course of action to address the child’s condition. If you would like the child’s PCP to help if you feel the child has depression, anxiety, ADHD, or opioid use concerns, you should call the child’s PCP directly.  

You do not need a referral from the child’s PCP for behavioral health services. If you would like behavioral health services, call the behavioral health provider directly to set up an appointment. You can also call Mercy Care DCS CHP Member Services at 602-212-4983 or 1-833-711-0776 (TTY/TDD 711) for help with finding a behavioral health provider. 

Eligible children and young adults under age 18 in foster care can receive medically necessary, trauma informed behavioral health and substance use services, covered under their DCS CHP health plan.   Young adults over age 18 participating in Extended Foster Care whose behavior indicates need for a substance use assessment, treatment or recovery may receive funding for services through their Arizona Complete Care (ACC) Plan if Title XIX or non-Title XIX services through the Regional Behavioral Health Authority (RBHA) and not covered under the Young Adult Transitional Insurance (YATI).

How to Obtain Substance Use Services

For children in DCS out-of-home care who are not connected with behavioral health services and whose behaviors indicate a need for substance use assessment or treatment services, the caregiver or guardian can call an Assigned Behavioral Health Clinic directly to schedule an intake.  They can also call Mercy Care at 602-212-4983 or toll-free 1-833-711-0776 (TTY/TDD 711) for help finding an Assigned Behavioral Health Clinic.  Member Services is available Monday through Friday, 7 a.m. to 6 p.m. The Assigned Behavioral Health Clinic will complete a full assessment of the child and will work with the guardian, caregiver and the child to decide on the type of services needed. 

If the child is currently receiving behavioral health services, the caregiver or guardian can contact the child’s Assigned Behavioral Health Clinic and/or their Child and Family Team (CFT) about the behaviors and the CFT will decide on the type of services needed.

Young adults participating in Extended Foster Care should contact their assigned ACC Plan if Title XIX eligible or the RBHA in their area if they are not covered under an ACC plan.  If the young adult lives in Maricopa County and is not covered under an ACC Plan, they can also call Mercy Care RBHA at 602-586-1841 or toll-free 1-800-564-5465 (TTY/TDD 711) for help finding a behavioral health and substance use provider.

Substance Use Prevention Resources

Alcohol and drug use are an ongoing problem in the United States. Substance use affects people of all ages and upbringings. Drugfree.org reports that 90% of people who live with addiction started using substances in their teen years. It’s common for some young people ages 12 to 21 to try drugs and/or alcohol to fit in socially or to dull trauma and pain. 

As a caregiver, it’s important to monitor the youth in your care. Talk to them about the dangers of substance use and how to know when to get help.

Below are additional resources to help start substance use prevention conversations with youth in foster care.

Websites:

Substance Abuse and Mental Health Services Administration

Partnership to End Addiction

Substance Abuse Coalition Leaders of Arizona

 

Serious mental illness (SMI) is a description used in Arizona for people who need additional support because their mental health impacts their ability to function. Additional services available to those who have a SMI designation can include housing, help from human rights advocates, case management, Assertive Community Treatment (ACT) and more. The SMI diagnoses considered are:  

  • Psychotic disorders  
  • Bipolar disorders 
  • Obsessive-compulsive disorders  
  • Depressive disorder  
  • Mood disorders  
  • Anxiety disorder  
  • Post-Traumatic Stress Disorder (PTSD) 
  • Personality disorders  
  • Dissociative Disorder  

To be eligible for SMI services, a person must have both an SMI qualifying condition and functional impairment caused by the qualifying condition. Providers are required to screen individuals for potential SMI. Adults receiving general mental health or substance use services must be regularly screened for SMI. Transition aged youth (TAY) may be screened as part of their transition into adulthood. Members that do not have a CFT or a Children’s Provider can call Mercy Care DCS CHP Member Services to set up an SMI determination screening.  

A member’s guardian or legal representative can also make the request. If a hospital requests an evaluation, it is considered an Urgent Referral and the contracted provider will go out within 24 hours to do the evaluation.  

Members must be at least 17 and half years of age to have a SMI evaluation. SMI evaluations must be completed within 7 business days of the SMI determination referral request. Providers then send their SMI evaluation packets to Crisis Response Network, Inc. (CRN). CRN reviews all applications for SMI services and makes the determining entity to make the final SMI determination. CRN makes its determinations about eligibility for SMI services by following the state's guidelines/criteria. Members will be sent a written notice of the SMI determination decision within three business days of the initial assessment. The written notice will include information about the member’s right to appeal the decision.  

For more information about getting a Serious Mental Illness (SMI) designation, you can call Mercy Care DCS CHP Member Services. at 602-212-4983 or 1-833-711-0776 (TTY/TDD 711). You can also call the Crisis Response Network at 602-845-3594 or 1-855-832-2866. 

Admission is based on medical need as outlined in AHCCCS Medical Policy Manual (AMPM) - AMPM Policy 320-V.

Member has a diagnosed behavioral health condition, and has symptoms and behaviors necessary for a request for residential treatment. The behavioral health condition causing the significant functional and/or psychosocial impairment is shown in the assessment by the following:

  1. At least one area of significant risk of harm within the past three months as a result of:
    1. Suicidal/aggressive/self-harm/homicidal thoughts or behaviors without current plan or intent,
    2. Impulsivity with poor judgment/insight,
    3. Maladaptive physical or sexual behavior,
    4. Inability to remain safe within environment, despite environmental supports (i.e. informal supports), or
    5. Medication side effects due to toxicity or contraindications.

AND

  1. At least one area of serious functional impairment as evidenced by:
    1. Inability to complete developmentally appropriate self-care or self-regulation due to behavioral health condition(s),
    2. Neglect or disruption of ability to attend to majority of basic needs, such as personal safety, hygiene, nutrition, or medical care,
    3. Frequent inpatient psychiatric admissions, or legal involvement due to lack of insight or judgment associated with psychotic or affective/mood symptoms or major psychiatric disorders,
    4. Frequent withdrawal management services, which can include but are not limited to, detox facilities, MAT, and ambulatory detox,
    5. Inability to independently self-administer medically necessary psychotropic medications despite interventions such as education, regimen simplification, daily outpatient dispensing, and long-acting injectable medications, or
    6. Impairments persisting in the absence of situational stressors that delay recovery from the presenting problem.
  2. A need for 24 hour behavioral health care and supervision to develop adequate and effective coping skills that will allow the member to live safely in the community,
    1. Anticipated stabilization cannot be achieved in a less restrictive setting,
    2. Evidence that appropriate treatment in a less restrictive environment has not been
    3. successful or is not available, therefore warranting a higher level of care, and
    4. Member agrees to participate in treatment. In the case of those who have a Health Care Decision Maker (HCDM), including minors, the HCDM also agrees to, and participates as part of, the treatment team. Agreement to participate in treatment is not a requirement for individuals who are court ordered to a secured BHRF.

There are laws about who can see the member’s behavioral health information with or without permission. Substance use treatment and communicable disease information (for example, HIV/AIDS information) cannot be shared with others without written permission. 

At times, permission is not needed to share your behavioral health information to help arrange and pay for your care. These times could include the sharing of information with: 

  • Physicians and other agencies providing health, social, or welfare services 
  • The member’s medical and behavioral health providers 
  • Certain state agencies involved in the member’s care and treatment, as needed 
  • Members of the clinical team involved in the member’s care 

  

At other times, it may be helpful to share the member’s behavioral health information with other agencies, such as schools. Written permission may be required before the member’s information is shared. 

A foster parent, group home staff or other person or agency in whose care the child has been placed by the Department of Child Safety (DCS) can consent to evaluation and treatment for routine medical and dental treatment and procedures, including behavioral health services. 

Examples of behavioral health services to which out-of-home caregivers can give consent include:  

  • Assessment and service planning 
  • Counseling and therapy 
  • Rehabilitation services 
  • Medical services 
  • Psychiatric evaluation 
  • Most psychotropic medication 
  • Laboratory services 
  • Support services 
  • Care management 
  • Family support 
  • Respite 
  • Sign language or oral interpretive services  
  • Transportation 
  • Crisis intervention services