This is a list of some of the important words and phrases you may hear while you work with MCCMH. If you have questions about the terms we are using when you receive our services, ask us! We want you to be actively involved in your services.
Adult Benefits Waiver: Michigan health care program for certain low-income adults who are not eligible for the Medicaid program. Contact the Community Relations/ Customer Service Office for more information. This is a narrowly defined benefit that does not entitle you to all of the services and supports described in this brochure.
Advance Directive for Mental Health Care: Also known as a “Psychiatric Advance Directive” is a legal document in which you name someone else, called a Patient Advocate, who is authorized to make medical care decisions for you if you are unable to make them yourself.
Alternative Dispute Resolution Process: If you do not receive Medicaid, this is the process used to request a hearing of your concerns about MCCMH services by the Department of Community Health in Lansing. The Ombudsman will help you make this request.
Appeal: A formal request for a review of an action made by MCCMH. You may file an Appeal if you do not agree with our decision to reduce, suspend, or terminate your services, or if you don’t agree with the contents of your person-centered plan (your plan of service), or if you don’t agree with our decisions about your eligibility for Family Support Subsidy payments. If you do not have Medicaid and are paying for part of the cost of your services, but you don’t agree with the fee we set for you, you may also file an appeal. for people with substance use disorders.
Commission on Accreditation of Rehabilitation Facilities, usually called CARF: CARF is a national organization that independently reviews the services of mental health and disability service organizations. MCCMH is accredited by CARF.
Confidentiality: Privacy. If you are receiving services from MCCMH, you have the right to have information about your services kept private.
Coordination of Care: MCCMH will talk with your primary doctor to make sure that your physical and mental health care, including all the medicines you take and any other treatments you receive, work together well. This is coordination of care.
Deductible (or Spend-Down): A term used when individuals qualify for Medicaid coverage even though their countable incomes are higher than the usual Medicaid income standard. Under this process, the medical expenses that an individual incurs during a month are subtracted from the individual’s income during that month. Once the individual’s income has been reduced to a state-specified level, the individual qualifies for Medicaid benefits for the remainder of the month.
Developmental Disability: As defined by the Michigan Mental Health Code means either of the following: (a) If applied to a person older than five years, a severe chronic condition that is attributable to a mental or physical impairment or both, and is manifested before the age of 22 years; is likely to continue indefinitely; and results in substantial functional limitations in three or more areas of the following major life activities: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency; and reflects the need for a combination and sequence of special, interdisciplinary, or generic care, treatment or other services that are of lifelong or extended duration; (b) If applied to a minor from birth to age five, a substantial developmental delay or a specific congenital or acquired condition with a high probability of resulting in a developmental disability.
Discharge Plan: A plan created with you before you leave the hospital that will outline what mental health services you will receive in the community to help you stay well.
Fair Hearing: A state level review of Medicaid beneficiaries’ disagreements with health plans’ denial, reduction, suspension or termination of Medicaid covered services. State administrative law judges who are independent of the Michigan Department of Community Health perform the reviews.
Family-Centered Planning/ Family-Centered Practice: Service planning that includes the goals, hopes and needs of the whole family. Most often used when children receive MCCMH services.
Fiscal Intermediary: A person who helps you manage your budget and pay your providers if you are using a self-determination approach.
Grievance: An expression of dissatisfaction with something about your service delivery or your experience with one of our staff, contractors, or service sites. The Ombudsman will help you if you have a grievance.
General Fund (GF) Services: These are MCCMH mental health or developmental disability services available to persons who do not receive Medicaid or do not have other insurance. These services are funded through Michigan’s General Fund.
Health Insurance Portability and Accountability Act of 1996 (HIPAA): This legislation is aimed, in part, at protecting the privacy and confidentially of patient information. “Patient” means any recipient of public or private health care, including mental health care, services.
Independent Facilitator: An independent facilitator is a person who has been trained to support others as a PCP facilitator. He or she is not connected to MCCMH or the agencies that provide your services. Independent facilitators are paid to facilitate PCP meetings, but don’t provide other services to you.
Individual Budget: The amount of funds available to you for purchase of your services if you are using a self-determination approach. Your individual budget is determined by your person-centered plan.
Individual Plan of Service: The written plan that provides you with the detailed information about the approved services you will receive from MCCMH and who will provide them. Your Individual Plan of Service is also known as your Person-Centered Plan, and is developed using the Person-Centered Planning model.
MDCH: An acronym for Michigan Department of Community Health. This state department, located in Lansing, oversees publicly-funded services provided in local communities and state facilities to people with mental illness, developmental disabilities and substance use disorders.
Medicaid-Covered Services: The healthcare services paid for by Medicaid. Most MCCMH services are supported by Medicaid.
Medicaid Health Plans (MHPs): The health insurance providers authorized by the State of Michigan to manage health services for Medicaid beneficiaries.
Medically Necessary: A term used to describe one of the criteria that must be met in order for a beneficiary to receive Medicaid services. It means that the specific service is expected to help the beneficiary with his/her mental health, developmental disability or substance use (or any other medical) condition. Some services assess needs and some services help maintain or improve functioning.
Michigan Mental Health Code: The state law that governs public mental health services provided to adults and children with mental illness, serious emotional disturbance, and persons with developmental disabilities by local community mental health services programs and in state facilities.
Michigan Public Health Code: One of many laws that govern the delivery of publicly-funded substance abuse treatment services, and other health/ medical services in Michigan.
MIChild: a Michigan healthcare program for low-income children who are not eligible for the Medicaid Program. This is a limited benefit. Contact the Community Relations/ Customer Services Office for more information.
Office of Community Relations: An information resource for service users, their families and friends, and the whole community who want to learn about MCCMH. The Office of Community Relations functions as the Customer Services office for MCCMH.
Office of Recipient Rights (ORR): The Office of Recipient Rights is the place at MCCMH that will help you learn about your rights. ORR will help you learn about your rights or file a Recipient Rights complaint.
Ombudsman: The Ombudsman is the person at MCCMH who will help you use informal dispute resolution processes, or will help you with a grievance. The Ombudsman is part of the Office of Community Relations.
Peer Facilitator: A Peer Facilitator is a person with mental illness or developmental disability who has been trained to support others as a Person-Centered Planning (PCP) facilitator. Peer facilitators are paid to facilitate PCP meetings, but don’t provide other services to you.
Person-Centered Planning: The process we use to design your services. PCP is based on your goals, strengths, abilities, and choices. PCP should build on your ability to be part of your community, and help you achieve your goals. Your person-centered plan defines what services you will get from MCCMH.
Psychiatric Evaluation: Questions or tests to help a doctor understand what you are feeling, seeing, or experiencing, and how well you understand what is going on around you. An evaluation is done before you receive treatment.
Recovery: A journey of healing and change allowing a person to live a meaningful life in a community of their choice, while working toward their full potential.
Resiliency: The ability to “bounce back.” This is a characteristic important to nurture in children with serious emotional disturbance and their families. It refers to the individual’s ability to become successful despite challenges they may face throughout their life.
Release of Information: A form that tells MCCMH who you want us to talk to about your treatment, and what information we can share or receive. Sometimes this is simply called a “release.”
Second Opinion: A review of the decision made by MCCMH about your request for hospitalization or your initial request for MCCMH services. Second opinions are provided by the MCCMH Executive Director, the Medical Director, or someone they authorize to do the review.
Self-determination: A model of service delivery that allows the person receiving mental health or developmental disability services to direct the purchase of approved services using a fixed amount of Medicaid dollars. Other public funds may also be used. Self-determination is an option for any adult who receives public mental health services.
SED: An acronym for Serious Emotional Disturbance, and as defined by the Michigan Mental Health Code, means a diagnosable mental, behavioral or emotional disorder affecting a child that exists or has existed during the past year for a period of time sufficient to meet diagnostic criteria specified in the most recent Diagnostic and Statistical Manual of Mental Disorders; and has resulted in functional impairment that substantially interferes with or limits the child’s role or functioning in family, school or community activities.
Serious Mental Illness: Is defined by the Michigan Mental Health Code to mean a diagnosable mental, behavioral or emotional disorder affecting an adult that exists or has existed within the past year for a period of time sufficient to meet diagnostic criteria specified in the most recent Diagnostic and Statistical Manual of Mental Disorders; and that has resulted in function impairment that substantially interferes with or limits one or more major life activities.
Substance Use Disorder (or substance abuse): Is defined in the Michigan Public Health Code to mean the taking of alcohol or other drugs at dosages that place an individual's social, economic, psychological, and physical welfare in potential hazard or to the extent that an individual loses the power of self-control as a result of the use of alcohol or drugs, or while habitually under the influence of alcohol or drugs, endangers public health, morals, safety, or welfare, or a combination thereof.
Treatment Planning / Service Planning: The development and review of your individual plan of services. At MCCMH, treatment/ service planning is done using the person-centered planning model.