2. A systems is in place to ensure coordination of mental health care with primary care, case management, harm reduction, substance use treatment, social and legal services, rehabilitation and self-help programs, as appropriate. |
- There are written policies and procedures regarding care coordination with other service providers.
- The primary medical provider is identified in each client record.
- Mental health care is coordinated with other internal and external services, including primary care, case management, harm reduction, substance use services, social and legal services, rehabilitation and self-help programs.
- There is evidence of effective referral relationships for the full range of services necessary to improve health outcomes, including:
- Primary care
- Mental health
- Case management (including COBRA, community based and medical case management programs)
- Harm reduction
- Substance use treatment
- Criminal justice
- Social and legal services, and self-help programs as appropriate
- The mental health program coordinates services with other programs serving PLWHAs, including the Ryan White HIV Care Network(s) in the proposed service delivery area(s) and Special Needs Plans (if applicable).
- Client charts reflect evidence of case conferencing with providers of other systems of care, as appropriate.
- Patient records include summary information from other service providers, as appropriate.
- Appropriate releases (HIV/AIDS, mental health and substance use) are on file in the client chart for any incoming and outgoing patient information.
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