Sandhills Center
Process Informing Access to B-3 Peer Support Services
(Adults with MH/SA)
Revised 05/13/14
For members who do not have a “Clinical Home” and are living in the community and are not receiving enhanced service(s):
· Members age 18 or older (and/or their legal guardian or representative) will call the Sandhills Center 1-800 number.
· If they are connected with a Customer Service representative they will ask to talk with a Call Center clinician
· The member will tell the Call Center clinician that they are interested in receiving Peer Support Services
· The Call Center clinician will collect pertinent information and provide the caller with the names of credentialed Peer Support service providers
· The chosen provider will submit the TAR, PCP or Service Plan, and any other pertinent documentation to the Sandhills Center Utilization Management Department (UM) via the SHC software system
· The request will be reviewed by UM and the disposition submitted in keeping with SHC procedures
For members who have a “Clinical Home” and are living in the community and are receiving enhanced service(s):
· Members age 18 or older (and/or their legal guardian or representative) will discuss their desire for Peer Support Services with their current provider (“clinical home”)
· The member and their legal guardian representative will engage in developing goals that can be met via the service and add those goals to the current PCP
· The provider will assist the member/guardian in making a call to the Sandhills Center 1-800 number if assistance is needed in identifying credentialed providers of Peer Support Services
· If they are connected with a Customer Services representative they will ask to talk with a Call Center clinician
· The member will tell the Call Center clinician that they are interested in receiving Peer Support Services
· The Call Center clinician will collect pertinent information and provide the caller with the names of credentialed Peer Support service providers
· A Qualified Professional from the member’s “clinical home” will participate in the assessment with the chosen Peer Support provider.
· The chosen provider will submit the TAR, PCP or Service Plan, and any other pertinent documentation to the Sandhills Center Utilization Management Department (UM) via the SHC software system.
· The request will be reviewed by UM and the disposition submitted in keeping with SHC procedures.
For members in the special population receiving treatment planning who have Serious and Persistent Mental Illness (SPMI) who reside in an Adult Care Home or those being diverted from entry into an Adult Care Home due to the PASSR process, or individuals transitioning from Adult Care Homes and State Psychiatric Units:
· The Sandhills Center Transition Coordinator or Peer Support Specialist will discuss the availability of this and other pertinent B-3 Services with the member during the initial and final transition meeting and during initial and follow-up in-reach interviews
· The Sandhills Center Transition Coordinator will include the member’s response to the offer of Peer Support services in pertinent documentation
· The Sandhills Center Transition Coordinator provides the member, their legal representative/guardian, and chosen provider, with the names of credentialed Peer Support service providers
· If the member expresses a desire for the service, the Sandhills Center Transition Coordinator or Peer Support Specialist ensures that the service is included in the Person Centered Plan written by the member’s chosen provider
· The member’s chosen provider or chosen “clinical home” will submit the TAR, PCP or Service Plan, and any other pertinent documentation requesting the Peer Support Service as well as any other chosen service to the Sandhills Center Utilization Management Department (UM) via the SHC software system.
· The request will be reviewed by UM and the disposition submitted in keeping with SHC procedures.