Gila River Health Care Corporation
Gila River Health Care Corporation
PROVIDER MANUAL
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Arizona Department of Health Services

Division of Behavioral Health Services
PROVIDER MANUAL
Gila River Regional Behavioral Health Authority Edition


Section 3.6 Member Handbooks

3.6.1 Introduction
3.6.2 Terms
3.6.3 Procedures
3.6.3-A. General
3.6.3-B. Distribution

3.6.3-C. Member Handbook Review
3.6.4 References
3.6.5 Forms


3.6.1 Introduction
To establish the responsibility of providers to distribute member handbooks to new enrollees and all persons receiving behavioral health services.

Member Handbooks are intended to provide information to behavioral health recipients and potential enrollees regarding the availability of services in the public behavioral health system. The Member Handbook provides information regarding how to obtain services, what services are available, what service limitations exist for Title XIX/XXI and Non-Title XIX/XXI persons and behavioral health recipient rights and responsibilities, among other topics. This information is imperative in ensuring that behavioral health services are accessible.

3.6.2 Terms
Definitions for terms are located online at http://www.azdhs.gov/bhs/definitions/index.php. The following terms are referenced in this section:

Limited English Proficiency

3.6.3 Procedures

3.6.3-A. General
The Member Handbook must be printed in a type-style and size which can easily be read by behavioral/physical health recipients with varying degrees of visual impairment, such as large print and other alternative formats included but not limited to audio and/or Braille.

ADHS/DBHS templates for the T/RBHAs’ use in developing T/RBHA versions of the member handbooks are available on the ADHS/DBHS website in both English and Spanish (see ADHS/DBHS and T/RBHA Member Handbooks).

Member handbooks must be written to adhere to the specifications outlined in the AHCCCS Member Handbook Checklist in the ACOM Chapter 400, Policy 404. Member handbooks must also include all information specified in 42 CFR 438.10.

3.6.3-B. Distribution
Member handbooks must be distributed to persons receiving services as follows (see AHCCCS ACOM Chapter 400, Policy 404 for more information):

  • members diagnosed with SMI who are enrolled with a T/RBHA must receive a member handbook within 12 business days of receipt of notification of the enrollment date;
  • members diagnosed with SMI who are enrolled with the Integrated RBHA must receive a member handbook within 12 business days of receipt of notification of the enrollment date; and
  • members enrolled with the T/RBHAs and the Integrated RBHA who are not diagnosed with SMI, must receive a member handbook within 12 business days of the member receiving his/her first service.

Documentation of receipt of the member handbook must be filed in the member's record. (Please see PM Form 3.6.1 Member Handbook Receipt for the minimum requirements to document members' receipt of the handbook.

Member Handbooks must be available and easily accessible at all provider sites and each T/RBHA website. Upon request, copies must be made available to known consumer and family advocacy organizations and other human service organizations.

The Member Handbook must be made available in identified prevalent non-English languages when the T/RBHAs are aware that another language is spoken by three thousand (3,000) or ten percent (10%), whichever is less, of the behavioral health recipients in a geographic region who also have Limited English Proficiency (LEP).

Persons receiving behavioral/physical health services have the right to request and obtain a Member Handbook at least annually. T/RBHAs must notify persons of their right to request and obtain a Member Handbook at least annually by publishing this information using T/RBHA communications such as the T/RBHA webpage, newsletter, etc.

ADHS/DBHS may require the T/RBHA to revise the Member Handbook and distribute it to all current enrollees if there is a significant program change. ADHS/DBHS determines if a change qualifies as significant.

3.6.3-C. Member Handbook Review

Member Handbooks are reviewed annually, and if needed, updated by the Arizona Department of Health Services/Division of Behavioral Health Services (ADHS/DBHS) and the Tribal and Regional Behavioral Health Authorities (T/RBHAs).

Any approved revisions or updated versions of the Member Handbook must be posted to the T/RBHA website by the effective date of such revisions or updates.

The content of the ADHS/DBHS Member Handbook Template must not be changed without prior written approval by ADHS/DBHS.

3.6.4 References
The following citations can serve as additional resources for this content area:

3.6.5 PM Forms

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3.6 Member Handbooks
Last Revised: 2/5/2014
Effective Date: 2/5/2014

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