Chapter 2. Customer Services & the Access System

The Thumb Alliance PIHP offers a Customer Services Department to answer your questions about the public system for treating mental health and substance use disorders. The Customer Services Department includes the Access Center, where you and other residents can request mental health and substance use disorder services.

The Thumb Alliance PIHP has a "no wrong door" policy when it comes to seeking services. You may walk into or call any of our facilities and you will be linked to the Access Center. You and other residents of Lapeer, St. Clair and Sanilac counties use the same Access Center to find out if you are qualified to receive services. All calls are private and confidential.

If you call for services, our trained and licensed clinicians will talk with you to determine your needs and your eligibility. If you are eligible, we will link to mental health and/or substance use disorder services. If you are not eligible, we will refer you to another agency that may be able to help you.

How to Contact Customer Services and the Access Center

• Customer Service and the Access Center are open Mondays-Fridays from 8 a.m.-5 p.m. for telephone screenings and to provide information about the public mental health and substance use disorder system.

• For general information, call Customer Services at (888) 225-4447.

• To get services, call the Access Center at (888) 225-4447.

• TTY: (888) 225-1973.

• Crisis help is available by calling these numbers 24 hours a day.

Customer Services

In addition to screening you and other callers for services, Customer Service technicians can provide you with information that you have a right to receive. Customer Services can:

• Assist you with the grievance and appeal process and the local dispute resolution process.

• Put you in touch with your Recipient Rights officer or a Fair Hearing officer.

• Provide you with a list of all Thumb Alliance PIHP service providers - organizations and individual practitioners - and tell you the services they offer, languages they speak, their specialties and how they perform in terms of meeting state and federal requirements.

• Provide you with annual reports, board of directorships, board meeting schedules, and board meeting minutes for the Thumb Alliance PIHP, Lapeer County CMH, St. Clair County CMH or Sanilac County CMH.

• Provide you with the Thumb Alliance PIHP's organizational chart.

• Answer your questions about mental health and substance use disorders - and more.

Qualifying for Services

The Thumb Alliance PIHP serves people who have Medicaid insurance or Adult Benefits Waiver, people who are enrolled in the MI CHILD program, and people who have no insurance and cannot pay for services. Michigan has a managed care delivery system for public services for mental health and substance use disorders. The Michigan Department of Community (MDCH) sets the rules and regulations that the Thumb Alliance PIHP and the local CMHs must follow. This includes the types of services that we provide and the criteria we use to determine if you are qualified to receive services.

Medicaid recipients are guaranteed to receive services that are medically necessary. For people who have no insurance or who are enrolled in MI CHILD, there is no guarantee that they will get services if there is not the money to provide those services. The Thumb Alliance PIHP and the local CMHs must provide service to as many people as possible within the financial resources available.

For mental health services, priority is given to 1) people with the most severe forms of serious mental illness, serious emotional disturbance or developmental disability, and 2) to people in urgent or emergency need.

For substance use disorder services, priority is give to 1) pregnant women who inject drugs, 2) pregnant women with have a SUD, 3) people who inject drugs, and 4) a parent whose child has been or may soon be removed from the home under the Michigan Child Protection Laws

Medical Necessity

The services we authorize to treat your mental health or substance use disorder must be medically necessary. You must need to receive the services. Medical necessity also means that the amount (how much of a service you get), scope (who provides the service and how) and duration (how long the service will last) of your services are enough to meet your needs.

Making Your Service Experience the Best Possible

• Language Assistance

If you use a TTY, please contact Customer Services at the following TTY phone number: (888) 225-1973. If you need a sign language interpreter, contact the Customer Services at (888) 225-4447 as soon as possible so that one will be made available. Sign language interpreters are available at no cost to you.

You may ask for the Customer Handbook in large print and recorded formats. If you do not speak English, contact the Customer Services office at (888) 225-4447 so that arrangements can be made for an interpreter for you. Language interpreters are available at no cost to you.

• Accessibility & Accommodations

In accordance with federal and state laws, all buildings and programs of the Thumb Alliance PIHP are physically accessible to individuals with all qualifying disabilities. Any individual who receives emotional, visual or mobility support from a service animal such as a dog will be given access, along with the service animal, to all buildings and programs of the Thumb Alliance PIHP. If you need more information or if you have questions about accessibility or service/support animals, contact Customer Services at (888) 225-4447.

If you need to request an accommodation on behalf of yourself or a family member or a friend, you can contact Customer Service. You will b told how to request an accommodation (this can be done over the phone, in person and/or in writing) and you will be told who at the agency is responsible for handling accommodation requests.

• Coordination of Care

To improve the quality of your services, the Thumb Alliance PIHP wants to coordinate your care with the medical provider who cares for your physical health. If you are receiving substance abuse services, your SUD care should be coordinated with your medical doctor. If you are receiving mental health services, your care should be coordinated your medical doctor. Being able to coordinate with all health care providers involved in treating you improves your chances for recovery, relief of symptoms and improved functioning. Therefore, you are encouraged to sign a "Release of Information" so that your information can be shared among your health care providers. If you do not have a medical doctor and need one, contact the Customer Services and the staff will assist you in getting a medical provider.

• Providing Information

To get the best care possible, tell your provider about your mental health and/or substance use history, including past hospital stays, treatments and medications. Federal law protects the privacy of this information. Let your provider know all of the insurances you have, such as Blue Cross Blue Shield, Blue Care Network, Medicare, Medicaid or others. You will be asked to fill out a Financial Information and Payment Agreement. Depending on your situation, Medicaid may not cover some services that you need. For many of those services, your charges will be based on your income. That's the purpose of filling out the form.

If you move, call your service provider as soon as you can. If you have Medicaid, you must also tell your Michigan Department of Human Services caseworker.

• Appointments

Try to keep your appointments with your therapists, counselors and doctors. If you are unable to keep an appointment, let the provider know - a day before if possible. He or she may be able to use your time-slot to help someone else. If you do not receive Medicaid, there may be a charge for missed appointments. If you miss too many appointments, there may be other penalties, including stopping your services.