Health Care Resources for Arizona’s Low Income and Uninsured Families June 2014 Edition Produced by and distributed by: With the financial support of: Health Care Resources for Arizona’s Low Income and Uninsured Families Produced and distributed by Funding for this manual was made possible by a grant from Children’s Action Alliance is a non-profit, non-partisan organization dedicated to promoting the well-being of all of Arizona’s children and their families through research, policy development, media campaigns and advocacy. Children’s Action Alliance 4001 N. 3rd Street, Suite 160 Phoenix, AZ 85012 Phone: (602) 266-0707 Fax: (602) 263-8792 CAA Southern Arizona 33 S. 5th Ave. Tucson, AZ 85701-1800 Phone: (520) 329-4930 www.azchildren.org Electronic Document Navigation: To conveniently navigate the electronic version of this document, click on the topics below to link directly to the complete section within the document. Table of Contents I. Overview .................................................................................................................... 5 II. Health Insurance Marketplace ................................................................................ 6 III. AHCCCS Programs ................................................................................................ 10 a. b. c. d. Characteristics of Arizonans Who May Be Eligible for Medicaid ......................... 11 AHCCCS Acute Services ....................................................................................... 12 Arizona Long Term Care System (ALTCS) Services ............................................ 12 Who Decides AHCCCS Eligibility? ....................................................................... 13 Social Security Administration ........................................................................... 13 Arizona Department of Economic Security (DES) ........................................... 13 AHCCCS Administration ................................................................................... 13 e. Eligibility Requirements ............................................................................................ 14 f. What Does AHCCCS Health Insurance Cost? ........................................................... 14 g. How Does an AHCCCS Health Plan Work? ............................................................. 15 h. Choosing an AHCCCS Health Plan .......................................................................... 16 i. Choosing a Primary Doctor ........................................................................................ 18 j. Grievance and Appeal Process ................................................................................... 18 k. Programs by Covered Group ..................................................................................... 21 l. AHCCCS Programs .................................................................................................... 22 m. How to Order AHCCCS Applications ..................................................................... 40 n. AHCCCS Contact Information .................................................................................. 40 o. AHCCCS Enrollment Assistance .............................................................................. 41 IV. The Arizona Department of Economic Security (DES)....................................... 46 a. General Information ................................................................................................ 46 b. DES Family Assistance Offices .............................................................................. 47 V. Behavioral Health Resources ................................................................................. 49 a. b. c. d. e. f. What are Behavioral Health Services? ................................................................... 49 Maricopa County Emergency Services ................................................................... 49 Regional Behavioral Health Authorities (RBHAs)................................................. 50 Tribal RBHAs ......................................................................................................... 51 Community Based Agencies/Community Crisis Numbers..................................... 51 Support Groups ....................................................................................................... 52 VI. Community Health Centers ................................................................................... 56 a. What is Primary Care? ............................................................................................ 56 b. General Information About CHCs .......................................................................... 56 c. Community Health Center Locations ..................................................................... 58 VII. Dental Health ...................................................................................................... 63 a. Arizona Dental Association .................................................................................... 63 b. Arizona Dental Sealant Program ............................................................................ 64 c. Arizona School-Based Fluoride Mouthrinse Program ............................................ 64 d. Arizona Fluoride Varnish Program ......................................................................... 64 e. Other Organizations ................................................................................................ 65 f. Dental Treatment Referral List ............................................................................... 66 VIII. Native American Health Resources .................................................................. 72 a. General Information ................................................................................................ 72 b. American Indian Health Program (formerly “Indian Health Service”) .................. 72 c. Questions and Answers ........................................................................................... 72 IX. Services For Children With Special Needs ........................................................... 74 a. b. c. d. What are Special Needs? ........................................................................................ 74 Arizona Department of Education (ADE) Services ................................................ 74 Children's Rehabilitative Services .......................................................................... 75 Arizona Early Intervention Program, Division of Developmental Disabilities, and Arizona Long Term Care System .......................................................................... 75 e. Other Department of Health Services Programs ..................................................... 82 f. Social Security Benefits .......................................................................................... 82 g. Children in Foster Care/Comprehensive Medical and Dental Program ................. 82 h. Other Resources ...................................................................................................... 83 X. Small Business/Employer Health Resources ........................................................ 86 a. Small Business Health Options Program (SHOP) .................................................. 86 b. Arizona Small Business Association ...................................................................... 86 XI. Youth And Young Adults ....................................................................................... 89 a. Young Adult Transitional Insurance ....................................................................... 89 b. AHCCCS Care ........................................................................................................ 89 c. Continuing Education and Training ........................................................................ 89 Jobs Corps 89 Maricopa Community Colleges .......................................................................... 90 Other Community Colleges in Arizona: ............................................................ 91 d. Other Services for Youth ........................................................................................ 91 XII. Other Community Health Resources ................................................................ 94 a. Arizona Department of Health Services and County Health Departments............. 94 Health Start .......................................................................................................... 96 Women, Infants, and Children (WIC) ............................................................... 96 b. A to Z Child Health Links ...................................................................................... 97 c. Prenatal Care ........................................................................................................... 97 South Phoenix Healthy Start.......................................................................................... 97 d. Birth to Five Helpline ............................................................................................. 98 e. Centers for Independent Living (Arizona Statewide Independent Living Council)98 f. Child Care Resource and Referral .......................................................................... 99 g. Child Protective Services ........................................................................................ 99 h. Maternal, Infant and Early Childhood Home Visiting Programs ......................... 100 i. Community Information and Referral .................................................................. 101 j. Domestic Violence ................................................................................................ 101 k. l. m. n. o. p. q. r. s. t. u. v. w. x. y. z. aa. bb. cc. dd. ee. ff. gg. hh. ii. jj. kk. Family Planning .................................................................................................... 101 Nutrition Assistance (formerly the Food Stamp Program) and Food Banks ........ 104 Head Start.............................................................................................................. 105 Homeless Services ................................................................................................ 106 Immunizations....................................................................................................... 117 Flu Clinics ............................................................................................................. 118 Legal Aid .............................................................................................................. 118 Gay, Lesbian, Bisexual, Transgender Resources .................................................. 120 Medical Services Project....................................................................................... 121 Medical Networks - Discounted Health Services ................................................. 122 Pima Community Access Program (PCAP) .................................................... 123 Community Access Programs of Arizona- Mexico (CAPAZ-MEX) ............. 123 Santa Cruz Health Connection ......................................................................... 124 Prescription Drug Discount Programs .................................................................. 124 School-Based Health Centers ............................................................................... 125 Sexually Transmitted Diseases ............................................................................. 125 Social Security Administration ............................................................................. 129 Spanish-English Hotline ....................................................................................... 129 Substance Abuse ................................................................................................... 130 Unemployment ...................................................................................................... 130 Veterans’ Services ................................................................................................ 131 Vision Benefits and Services ................................................................................ 133 Neighborhood Christian Clinic ............................................................................. 133 Neighborhood Outreach Access to Health (NOAH) ............................................ 133 Prescription Drug Benefit – CoppeRx® ............................................................... 134 Prescription Drug Benefit – Coast2CoastRx ........................................................ 134 Pre-existing Condition Insurance Plan (PCIP) ..................................................... 134 Mission of Mercy .................................................................................................. 135 HIV/AIDS ............................................................................................................. 135 Crews’n Healthmobile .......................................................................................... 138 XIII. Tools ................................................................................................................... 141 a. AHCCCS Income Eligibility Limits ..................................................................... 141 b. AHCCCS Program Eligibility............................................................................... 142 c. How to Apply for AHCCCS Programs ................................................................. 146 Federally Qualified Health Centers Facilitating Health-e-Arizona Applications ........................................................................................................ 147 d. Tips for Completing Your AHCCCS Application ................................................ 148 e. How to Renew your AHCCCS Coverage ............................................................. 150 f. How AHCCCS Health Plans Work ...................................................................... 150 g. Citizenship Requirements ..................................................................................... 151 I. Healthcare for Adults and Children: Health Insurance Marketplace & AHCCCS http://www.azahcccs.gov http://www.healthcare.gov I. Overview This manual provides detailed information about how families can access health care coverage and other benefits through AHCCCS (Arizona’s Medicaid agency) and the health insurance Marketplace. A family’s income will determine whether they qualify for an AHCCCS medical programs or subsidies to lower the cost of a health insurance plan purchased through the Health Insurance Marketplace. There are many different health coverage programs within AHCCCS and each will have its own income requirements. Filling out an AHCCCS application will determine which program an applicant is qualified for. Due to the Affordable Care Act, AHCCCS health plans have expanded coverage to higher income levels than in the past. Families who earn too much to qualify for Medicaid may still receive financial assistance to purchase a health plan on the Marketplace. Anyone who does not qualify for an AHCCCS health plan can apply for a health plan on the Marketplace, but whether they qualify for financial benefits will depend on the family’s income, employment benefits, and residency status. AHCCCS and the Marketplace use different application systems. The application system used by AHCCCS is also used to apply for many other public benefits such as nutrition assistance, and each program has its own requirements. The Marketplace application system can only be used to apply for health insurance. Income requirements for various AHCCCS programs are discussed in this manual in the sections that follow and are also included in the tools section of this resource manual. The guideline for determining whether a family’s income qualifies them for AHCCCS programs or subsidized Marketplace plans is referred to as the Federal Poverty Level (FPL). To determine where to apply first, applicants can be screened by comparing their estimated family income to the income requirements for AHCCCS programs. If the applicant’s estimated income is below 150% of the FPL, then they should consider starting with the AHCCCS application. The table below can be used as a preliminary screening tool on whether to start with AHCCCS or the Marketplace. It is important to note that there are many AHCCCS programs with separate income requirements and it is worth contacting an application assister to consider options by dialing 211. Family size 1 2 3 4 5 If family income is LESS than 150% of FPL 150% of FPL If family income is OVER 150% of FPL $17,505 $23,595 Consider starting a $29,685 Marketplace application (Information on page 6) $35,775 $41,865 For families over 5 persons, add $6090 for each additional person Consider starting a AHCCCS application (Information on page 10) 5 A 2014 FPL chart is located in the tools section of this resource manual. Please see http://aspe.hhs.gov/poverty/ for the most current guidelines. The FPL is updated by the federal government every year and varies by family size. II. Health Insurance Marketplace The Patient Protection and Affordable Care Act (ACA) was signed into law by President Obama in March of 2010. Millions of Americans have already benefitted from many of the law’s provisions including coverage for preventive health services, ban on lifetime limits, and insurance coverage for young adults. On October 1, 2013 the Health Insurance Marketplace opened to enrollment. Arizona has elected to have the Federal Government operate the Marketplace for Arizona, which means that Arizonans can apply for coverage through the federally run website, www.healthcare.gov. The Marketplace is a new way to find quality health coverage for those who have no coverage now or who are looking at other options. With one Marketplace application, you can learn if you can get lower healthcare insurance costs based on your income, compare your coverage options side-by-side, and enroll. Tax credits to offset premiums and cost-sharing reductions that reduce out-of-pocket health costs are available based on income. Categories of Marketplace Insurance Plans There are five categories of Marketplace insurance plans: Bronze, Silver, Gold, Platinum, and Catastrophic. All Marketplace insurance plan categories offer the same set of essential health benefits. The categories do not reflect the quality or amount of care the plans provide. The category you choose affects how much your premium costs each month and what portion of the bill you pay for things like hospital visits or prescription medications. It also affects your total out-of-pocket costs —the maximum amount you’ll spend for the year if you need lots of care. When choosing your health plan, pay close attention to both the cost of the premium and the cost sharing details included in each plan and how it will relate to your health needs. Cost sharing includes health costs incurred through copayments, deductibles, and coinsurance. A plan with cheap monthly premiums may save you from paying a higher premium, but may actually result in higher overall costs when you access health care. It is important to look at the cost-sharing included in each plan when deciding which plan will best fit your health needs. Note that only plans purchased at the Silver level or above will qualify for tax credits to offset premium costs; and cost-sharing reductions only apply to Silver level plans. In addition to the premium and cost sharing details in each plan, make sure you check with the health insurance plan to see whether the providers that are under the plan meet your health needs. If you visit providers that are not covered under the plan, you may encounter significant health costs. Links to each plan are listed in the Qualified Health Plans section. 6 Essential Health Benefits Package All Marketplace plans are required to provide essential health benefits. The essential health benefit benchmark for Arizona is the State employee plan. Complete details are provided here, http://www.cms.gov/cciio/resources/data-resources/ehb.html - review. In general the ACA requires an essential health benefits package in every health plan to include services and items in these 10 broad categories of care: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services and chronic disease management Pediatric services, including oral and vision care* *Not all plans on the Marketplace include dental coverage for kids. This is because there are also separate, stand alone dental plans available for purchase. Stand alone plans do not qualify for premium tax credits. How to Apply to the Health Insurance Marketplace and AHCCCS? There are several ways to apply for health insurance using the Marketplace. You can go directly to www.healthcare.gov to learn more about the Marketplace and to apply for coverage. You can also receive assistance from a Navigator or an Assister, trained individuals available in the community to help you in completing the required application. Normally, you can only apply for the Marketplace during a certain time frame of the year known as Open enrollment. Open enrollment for the Health Insurance Marketplace begins November 15th and continues until February 15th. After the February 15th deadline, most applications will no longer be accepted; however, special circumstances such as the loss of a job, divorce, relocation, and other situations will allow you to apply. A list of these special circumstances is available at https://www.healthcare.gov/screener/marketplace.html?state=Arizona&path=marketplace Several plans on the Marketplace can be purchased outside of healthcare.gov directly from the health plan, but consumers should be advised that these plans will not be qualified for any tax credits or cost sharing reductions. The Health-e-Arizona Plus application at www.healthearizonaplus.gov serves as the application portal for the full range of AHCCCS benefits and local health programs, Nutrition Assistance 7 (Food Stamps) and Cash Assistance benefits. You can apply for AHCCCS at any time of the year. Navigators and Assisters Several Arizona organizations received grant funds from the Federal government to help provide outreach and enrollment assistance for the Marketplace. These organizations can be reached by dialing the state wide hotline 211. Personnel are trained to provide assistance and are strategically located throughout the state under the direction of the following organizations: · · · · Greater Phoenix Urban League, Inc. 602-254-5611 Arizona Alliance for Community Health Centers 602-253-0090 Arizona Board of Regents, University of Arizona 520-292-6900 or 520-512-0144 Campesinos Sin Fonteras, Inc 928-627-5995 Each of these organizations partner with many other local organizations to coordinate outreach opportunities throughout Arizona. A map to locate a site nearby is located at http://coveraz.org/navigators-and-assisters-map/ Consumers can also call 211 for statewide referral to a Navigator near the zip code they reside in. Direct access to the Marketplace application is at healthcare.gov or by calling 1-800-318-2596. Qualified Health Plans Offered on the Marketplace Health plans that are officially registered with the Marketplace are also known as Qualified Health Plans. Overall, Arizonans have nearly 1,200 options available statewide. Every year, health insurers will review the plans offered on the Marketplace and consider changes. Listed below are the names of the qualified health plans with details of the plans offered and links to additional information. Consumers can also go to healthcare.gov to look at the plans in their county. After purchasing a plan on the Marketplace, the consumer must pay the monthly premium to begin coverage. If you purchased a plan before the 15th of the month, then your coverage can begin as early as the 1st of the following month. If you purchased a plan after the 15th, then your plan will begin the month after the next month. Other sites are available to search qualified plan information by state and region. They include: · · ValuePenguin: http://www.valuepenguin.com/ Cover Arizona: http://coveraz.org/health-plan-information/ (Links to health plan formularies and provider networks are available and posted on this page also.) 8 Qualified Health Plan Health Net of Arizona Humana Health Plan, Inc. Aetna Blue Cross Blue Shield of Arizona, Inc. Health Net Life Insurance Company Meritus Mutual Health Partners Meritus Health Partners Health Choice Insurance Company Cigna Health and Life Insurance Company University of Arizona Health PlansUniversity Healthcare Marketplace Types of Plans Offered HMO, Catastrophic HMO, Catastrophic PPO, Catastrophic PPO, Catastrophic PPO PPO, Catastrophic HMO HMO PPO HMO Counties Where Options Available Maricopa, Pima, Pinal Number of Plan Options 56 Maricopa, Pima 10 Statewide 105 Statewide 495 Statewide 240 Statewide 135 Maricopa, Pima, Santa Cruz Apache, Coconino, Gila, Maricopa, Mohave, Navajo, Pima, Pinal Statewide 18 Cochise, Graham, Greenlee, LaPaz, Maricopa, Pima, Pinal, Santa Cruz, Yavapai, Yuma 32 135 51 Qualified Dental Plans are also available for purchase on the Marketplace. Arizona has five qualified dental plans available offering close to 400 different options to select a child’s plan or a family plan of coverage. Qualified Dental Plan Delta Dental of Arizona Dentegra Insurance Company Cigna Health and Life Insurance Premier Access Dental Types of Plans Offered PPO Pediatric and Family PPO Pediatric and Family PPO Pediatric and Family PPO Pediatric and Family Counties Where Options Available Statewide Number of Plan Options 120 Statewide 159 Statewide 30 Statewide 45 9 Humana Insurance Company PPO Statewide 15 Additional details regarding the qualified health plan formularies and county specific options are available at http://coveraz.org/health-plan-information/. III. AHCCCS Programs The Arizona Health Care Cost Containment System (AHCCCS, pronounced “access”) is the agency that administers the State’s quality low or no cost public health insurance programs for adults and children. In addition, many people use the term “AHCCCS” for the actual health insurance products administered by the agency (i.e., “I have AHCCCS”). The largest of these programs is Arizona’s version of the federal Medicaid program. Thus, the term AHCCCS is often used interchangeably with the term Medicaid in Arizona. AHCCCS also administers KidsCare, which provides health insurance for children in families who are two times above the poverty level. However, no new applications are being approved for KidsCare at this time. AHCCCS offers cost-effective, quality programs that provide health insurance to many people who would not otherwise be able to afford some or all of their medical bills. Over a million people have AHCCCS health insurance in Arizona. However, there are still many uninsured people in Arizona, and many of them are probably eligible for existing coverage that is explained in this Manual. Often, people don’t know they are eligible for Medicaid. AHCCCS health insurance is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Some AHCCCS members are required to pay a monthly premium or small copayment to help offset the cost of their medical care. The AHCCCS acute care program is a statewide, managed care system that delivers acute care services plus the American Indian Health Program. AHCCCS contracts with health plans and other program contractors, paying them a monthly “capitation” amount in advance for each enrolled member. The plan or contractor is then “at risk” to deliver the necessary services within the capitation amount. AHCCCS receives federal, state, and county funds to operate, plus some monies from Arizona’s tobacco tax. Eligibility is not performed by one agency, but by various agencies, depending on the category. For example, pregnant women, families, and children generally enter AHCCCS by way of the Department of Economic Security (DES). Individuals with blindness or another disability and the elderly who receive Supplemental Security Income (SSI) enter through the Social Security Administration (SSA). Eligibility for categories such as long-term care and Medicare Savings Programs is handled by AHCCCS. AHCCCS also handles SSI Medical Assistance Only (MAO), which is Medicaid for the aged, blind or disabled Medicaid categories. Each eligibility group has its own income and resource criteria. 10 Income guidelines for most AHCCCS programs are based on the Federal Poverty Level (FPL) set by the federal government. A 2014 FPL chart is located in the tools section of this resource manual. The FPL guidelines usually change annually. Please see http://aspe.hhs.gov/poverty/ for the most current guidelines. Some programs use the base Federal Poverty Level or 100% FPL. The FPL is updated by the federal government every year and varies by family size. Income guidelines for the Arizona Long Term Care System (ALTCS) program are determined at 300% of the Federal Benefit Rate (FBR). The FBR is the maximum paid by the SSA to persons determined to be eligible for SSI Cash. The FBR is updated every January by the federal government. a. Characteristics of Arizonans Who May Be Eligible for Medicaid · Child under 19 · · Individual with a disability Parent of minor child · · Blind individual Pregnant woman · · Low-income adult Individual 65 years of age or older 11 b. AHCCCS Acute Services · Doctor’s office visits and specialist care, if necessary · Hospital services and emergency medical care · Pregnancy care · Prescriptions & medical supplies (Note: prescription coverage is limited for persons entitled to Medicare) · Laboratory & X-ray services · 24-hour emergency medical care · Family planning services, but not abortion or abortion counseling · Preventative dental (children only) · Emergency dental · Complete physical exams · Shots · Hearing tests & hearing aids (for members under age 21) · Behavioral health services · Transportation c. Arizona Long Term Care System (ALTCS) Services All AHCCCS Acute services, plus Home- and Community-Based Services (HCBS): Note: this does not include community-based settings such as assisted living centers and homes and adult foster care homes, etc. · Home health nurse and/or aide · Homemaker · Personal and/or respite care · Attendant care · Transportation · Adult day health · Home delivered meals · Developmentally disabled day care Institutional care · Nursing facility · Intermediate care facility for Mental Retardation and Related Conditions 12 · Hospice · Behavioral health services For more information about ALTCS, please see the related section under Children with Special Health Care Needs. d. Who Decides AHCCCS Eligibility? Different government agencies are responsible for determining eligibility for different publicly funded health care programs. These agencies and the respective program for which eligibility is determined include: Social Security Administration · SSI Cash: In Arizona, SSI Cash recipients are automatically eligible for AHCCCS Health Insurance Arizona Department of Economic Security (DES) · AHCCCS Care (Low Income Adults) – Under the new Medicaid expansion that started on January 1, 2014, qualified individuals may again be covered up to 133% FPL or qualify for health insurance through the Health Insurance Marketplace · AHCCCS for Families and Children (Section 1931 of the Social Security Act) · SOBRA (Pregnant women & children under age 19) · Federal Emergency Services (FES [pregnant women, children, families regardless of immigration status]) · Young Adult Transitional Insurance (Children who turned 18 while in DES foster care and enrolled on Medicaid) The Affordable Care Act has expanded coverage for these youth until age 26 AHCCCS Administration · KidsCare (Children's Health Insurance Program [CHIP]) Enrollment Suspended · ALTCS (Arizona Long Term Care System) · SSI MAO (SSI Medical Assistance Only programs) · Medicare Savings Programs (AHCCCS pays Medicare premiums and deductibles and co-pays) 13 · Federal Emergency Services (FES [disabled, blind or 65 & older]) · Breast & Cervical Cancer Treatment Program · Freedom to Work · SSDI Temporary Medical Coverage – Program Suspended e. Eligibility Requirements General Requirements · · · · Arizona resident Citizen or qualified immigrant1 (only for the person for whom application is being made; for example, if child is the applicant, the parents’ citizenship status is not considered unless they are also applying for coverage) Income under specified limit Provide or apply for Social Security Number (Parents who are enrolling their children but not themselves DO NOT need to provide their own social security numbers) Specific Requirements (Do Not Apply to All Programs) · · · · · Resource limits Transfer of resources penalty Disability Age Not covered by Medicare, Medicaid, VA Medical or other health insurance f. What Does AHCCCS Health Insurance Cost? Co-Payments A co-payment is the amount an AHCCCS member pays to a provider to receive medical services. Co-payments (www.azahcccs.gov/members/copayments.aspx) have changed effective October 2010 for some AHCCCS members. The maximum co-pays are as follows: $5 $30 Physician visit Non-emergency use of the emergency room (A.A.C. R9-22-711.D.) The following AHCCCS members do not have a co-payment: · · · 1 Children under age 19 (including KidsCare) Pregnant women Individuals up through age 20 eligible for services from Children’s Rehabilitative Services (CRS) Program For more information on citizenship and qualified immigrant status, see the tools section at the end of this manual. 14 · · · · · · · · · Persons residing in medical institutions (e.g. hospital, nursing facility or ICF/MR) ALTCS eligible persons receiving Home- and Community-Based Services (Note: some exceptions apply) Persons receiving hospice care Persons enrolled in the ALTCS Program Persons with a serious mental illness (SMI) All fee-for-service populations Persons receiving family planning services Persons eligible for Medicare Cost Savings Programs Native Americans enrolled with the American Indian Health Program or eligible for Health Insurance for Parents or KidsCare Premiums All KidsCare households are charged a monthly premium based on their income and the number of children enrolled. KidsCare is currently frozen and no new enrollees are accepted; however current enrollees may stay on if they make their premium payments. KidsCare premium amounts are available at http://www.azahcccs.gov/applicants/categories/KidsCare.aspx#Premiums KidsCare premium notices are mailed out on the 1st of the month and payments are due by the 15th of the month. AHCCCS/KidsCare will notify recipients of any changes in premium amounts. Premium payments can be mailed, dropped off in person or paid online. · Mail: AHCCCS Health Insurance, PO Box 29144, Phoenix, AZ 85038 – 9144 · Drop Off In Person: AHCCCS Administration, 701 E. Jefferson, Phoenix, Arizona 85034 · Online: Go to www.myahcccs.com to pay premiums online. Coverage ends when premiums are more than one month in arrears (i.e., when payment is a month late). Overdue premiums must be paid before a family can be re-approved. g. How Does an AHCCCS Health Plan Work? AHCCCS is a statewide, managed care system that delivers services through prepaid, “capitated” health plans. AHCCCS contracts with health plans and other program contractors, paying them a monthly “capitation” amount for each enrolled member. The plan or contractor is then “at risk” to deliver the necessary services within the capitation amount. AHCCCS also contracts with American Indian Health Program (AIHP) to deliver care on a fee-for-service basis. The health plan works with health care providers (i.e., doctors, hospitals, pharmacies) to provide all AHCCCS covered services. 15 The health plan will send a member handbook when a person is enrolled. The phone number for member or customer services can be found in the Member Handbook and on the AHCCCS ID Card. A person can call the health plan with questions about benefits or services, or to request interpreter services or an accommodation for a disability. h. Choosing an AHCCCS Health Plan A person applying for AHCCCS needs to choose a health plan that serves their county (except for a few zip codes that cross county lines, which are noted on the application form). All AHCCCS health plans are required to provide the same array of services. Nonetheless, some differences do exist between health plans (for example, health plans may contract with different providers). Thus, it is wise for applicants to find out more information about the different health plans they may be eligible for before choosing a plan. Applicants should choose an AHCCCS health plan when they apply. Native Americans, who can receive services from AIHP, may choose either the AIHP or an AHCCCS Health Plan located in their county of residence. Individuals applying to AHCCCS who do not choose a health plan when applying will be assigned to a health plan by AHCCCS and given 30 days to choose another health plan if they wish. Individuals who have been enrolled in an AHCCCS health plan within the past 90 days will be enrolled with their previous health plan if it is available. A person who is approved for emergency services only will not be enrolled in an AHCCCS Health Plan. For a list of health plans organized by Arizona County, please refer to the chart below. AHCCCS Health Plans AHCCCS members must select a health plan that serves their county. The health plan should be selected when an AHCCCS application is filled out. Health Plans United Healthcare Community Plan (www.uhccommunityplan.com) 1 E. Washington St Phoenix, AZ 850004 Phone County Apache, Coconino, Cochise, Graham, Greenlee, La Paz, (800) 348-4058 Maricopa, Mohave, Navajo, Pima, Santa Cruz, Yavapai, Yuma 16 Health Plans Bridgeway Health Solutions (www.bridgewayhs.com) 1501 W. Fountainhead Corporate Park, Suite #295 Tempe, AZ 85282 Phone County (866) 516-7224 Yavapai Care 1st Health Plan Arizona (www.care1st.com) (602) 778-1800 2355 E. Camelback Street, Suite 300 Phoenix, AZ 85016 (866) 560-4042 Maricopa Health Choice Arizona (www.healthchoiceaz.com) (480) 968-6866 410 N. 44th Street, Ste 900 Phoenix, AZ 85008 (800) 322-8670 Apache, Coconino, La Paz, Maricopa, Mohave, Navajo, Pima, Santa Cruz, Yuma Maricopa Health Plan (www.mhpaz.com) (602) 344-8760 2502 E. University Drive, Suite 125 Phoenix, AZ 85034 (800) 582-8686 Mercy Care Plan (www.mercycareplan.com) (602) 263-3000 4350 E. Cotton Center Blvd, Bldg D Phoenix, AZ 85040 (800) 624-3879 Phoenix Health Plan (www.phoenixhealthplan.com) (602) 824-3700 7878 N. 16th Street, Suite 150 Phoenix, AZ 85020 (800) 747-7997 Maricopa Cochise, Graham, Greenlee, Maricopa, Pima Apache, Coconino, Gila, Maricopa, Mohave, Navajo, Pima, Pinal, Yavapai University Family Care (www.universityfamilycare.net) 2701 E. Elvira Road Tucson, AZ 85756 (520) 874-5290 Cochise, Gila, Graham, Greenlee. Pima, Pinal, Santa Cruz (800) 582-8686 Split ZIPS: 85220, 85342, 85353 and 85390 to Maricopa; 85292 to Gila; 85643 to Cochise, 85645 to Santa Cruz, 86336 and 86340 to Yavapai; and 86434 and 86351 to Coconino. 17 i. Choosing a Primary Doctor Each member must choose a primary doctor or one will be assigned. The health plan sends new enrollees a list of available primary doctors. The primary doctor will: · Take care of the person's health care. · Be responsible for obtaining authorization for medically necessary non-emergency medical services. · Refer the person to a specialist when needed. The person may change primary doctors by calling their health plan's member service or customer service department. Did You Know . . . ? Information on individual physicians (education, training, regulatory actions taken against them) can be found through the following state licensing boards: · Arizona Medical Board (480) 551-2700 www.azmd.gov · Arizona Board of Osteopathic Examiners (480) 657-7703 www.azdo.gov j. Grievance and Appeal Process AHCCCS members who disagree with decisions about the amount or type of services they receive can appeal these actions to their health plan. Appealable actions include: · Denial of requested services · Termination or reduction of services · Failure to take timely action They can also request a state fair hearing. Members who are unhappy about other aspects of their care (quality of service) can file complaints (grievances) to resolve the problem. Members must follow certain steps, beginning with contacting their health plan. Please see the Frequently Asked Questions (below) for more information about appealing an action or filing a complaint (grievance). Members Enrolled In a Health Plan – Appeal Process · Members enrolled in a health plan must appeal to their health plan. 18 · Members should refer to the member handbook provided by their health plan for instructions. If they are appealing an action, they must appeal to their health plan Claim Dispute and Appeal department. Their health plan should resolve their appeal within 30 days unless there is an extension. · If a member or a health service provider feels that the member’s health will be in serious jeopardy if they have to wait 30 days for a decision from their health plan, they can request an expedited appeal. If the expedited appeal request is accepted by the health plan, the health plan should resolve the appeal within three working days unless an extension is granted or the appeal is determined not to require expedited handling. · If the member disagrees with their health plan's decision after the member appeals an action, they can request a state fair hearing. · A member’s written request for a hearing must be filed with the health plan, which will forward it to AHCCCS to schedule a hearing. State fair hearings are only available when a health plan issues a decision on an appeal regarding the action. Grievances · If the member has a complaint (e.g. environmental conditions at a doctor's office, impoliteness or rudeness of providers) about something other than an action, the member can file a grievance with the health plan. The health plan's decision is final; there is no state fair hearing on the health plan's decision. · There is no state fair hearing for a health plan's decision on a grievance (that is a complaint about something other than an "action"). The health plan's decision on a grievance is final. Members Not Enrolled In A Health Plan (Fee-For-Service) · · Members not enrolled with a health plan are enrolled on a fee-for-service basis. If a member is AHCCCS eligible and not enrolled with a health plan, the member may contact AHCCCS Member Services with their complaint at (602) 417-4000 or (800) 6548713. · If the member is appealing an action, they must appeal to the AHCCCS Office of Administrative Legal Services (OALS). · If a member or a health service provider feels that the member’s health will be in serious jeopardy if they have to wait 30 days for a decision, they can request an expedited appeal. If the appeal is expedited, it will be scheduled directly to hearing and AHCCCS will mail a decision within three working days after the hearing. · If the AHCCCS decision on the appeal is unfavorable the member may request a state fair hearing. Their written request for a hearing must be filed with AHCCCS Office of Administrative Legal Services. See address below. AHCCCS Attention: Office of Administrative Legal Services 19 701 E. Jefferson, MD 6200 Phoenix, AZ 85034 (602) 417-4232 or (800) 654-8713 ext. 74232 Continuing Services During An Appeal · If a member is currently receiving services, the member may be able to continue to receive services during the appeal process. · If services were reduced, suspended or terminated the member may ask to continue to receive services during the appeal. Services will only be continued if they have already been approved and are being provided. To continue receiving the services the member must file their appeal before the day the reduction or termination is to take effect. If there is less than 10 days between the date of the notice of reduction, termination, and suspension and the effective date on the notice, they have 10 days from the date of the notice to request continued services. However, if the member loses their appeal, they may have to pay for the services they received during the appeal process. There are also rules regarding payment of the premium during an appeal process in order to continue services. · This is a summary of the grievance and appeal process. The complete rules can be found at Arizona Administrative Code (A.A.C.), Title 9, Chapter 34, (http://www.azsos.gov/public_services/Title_09/9-34.htm) Article 2 (enrolled members), and Article 3 (non-enrolled members). The Arizona Administrative Code can be found at the Secretary of State's Office Web site at www.azsos.gov or by following the previous hyperlink. Frequently Asked Questions 1. Who can file a complaint (grievance), appeal or request for hearing? An AHCCCS member, a guardian or conservator or an authorized representative appointed by the member may file. The member must identify the authorized representative in writing. 2. What actions can be appealed? A member can appeal any denial, reduction, suspension, or termination of service, or denial of claim payment for a non-covered service. This can include a failure to act timely. These are called “actions.” Examples include a denial of a request for surgery, a denial of a request for a wheelchair, a reduction in physical therapy days, etc. 3. What are the time frames for filing an appeal? The appeal must be filed (received) no later than 60 days from the notice of action. The notice of action describes the reasons for the action, and tells the member how to file an appeal. 20 4. What if the member needs help filing their appeal? Their health plan is required to provide reasonable assistance, including information on the process. 5. Who will make the decision on the member’s appeal? A qualified health care professional will make decisions on medical decisions. The person who reviews the appeal cannot be the same person who made the original decision. 6. What do you mean when you say "seriously jeopardizing one's health"? This means serious harm to member’s life or health or ability to attain, maintain or regain maximum function. k. Programs by Covered Group Different health insurance programs offered by AHCCCS are available for different "coverage groups.” · · · · · · Family Coverage Coverage for Children Only Coverage for Adults without Children Coverage for Women Only Senior Services Partial Coverage Family Coverage There are several AHCCCS programs available for families with children under the age of 19. AHCCCS Care, Health Insurance for Parents, AHCCCS Families and Children, Medical Expense Deduction, and SOBRA for Pregnant Women and Children are programs that aid children or the family as a whole. Individuals and families eligible for many AHCCCS programs in this coverage group may also be eligible for Cash Assistance, Supplemental Nutrition Assistance (SNAP, formerly Food Stamps) and Child Care Subsidy programs through the Arizona Department of Economic Security. Coverage for Children Only There are several AHCCCS programs available for children under age 19. KidsCare, SOBRA for Children and Arizona Long Term Care are programs that aid children. Young Adult Transitional Insurance (YATI) covers young adults leaving foster care that are under the age of 26. Coverage for Adults without Children There are several AHCCCS programs available for adults who do not have children under the age of 19 living with them (if there are children under 19 in the household, see Family 21 Coverage). AHCCCS, Arizona Long Term Care, and SSI Medical Assistance Only are programs that aid adults without children. Individuals eligible for many AHCCCS programs in this coverage group may also be eligible for Cash Assistance and/or TANF, and SNAP (formerly Food Stamp) programs through the Arizona Department of Economic Security. The Freedom to Work program offers assistance to employed adults who have a disability. Coverage for Women Only The following programs are available for women only: SOBRA for pregnant women and the Breast and Cervical Cancer Treatment Program. Senior and Disabled Services There are several AHCCCS programs available for seniors such as Medicare Cost Savings, SSI Cash/Medical Assistance Only and Arizona Long Term Care. For adults with disabilities, SSI MAO, Medicare Savings Programs, Freedom to Work, ALTCS are offered. Partial Coverage There are programs under the AHCCCS umbrella that provide limited coverage and do not include full health coverage benefits. These programs include Family Planning Services for women who were covered by AHCCCS when they gave birth to a child, and Federal Emergency Services (FES). FES coverage is limited to emergency situations, and Family Planning Services is limited to family planning and is only available for up to two years after the end of the pregnancy. l. AHCCCS Programs · · · · · · · · · · · · AHCCCS Care AHCCCS for Families and Children Arizona Long Term Care System (ALTCS) Breast and Cervical Cancer Treatment Program (BCCTP) Family Planning Services Federal Emergency Services (FES) Freedom to Work KidsCare- Enrollment Frozen Medicare Cost Savings Program SOBRA SSI CASH/SSI Medical Assistance Only (MAO) Young Adult Transitional Insurance (YATI) 22 AHCCCS Care for Adults without Children The AHCCCS Care program provides medical coverage, such as doctor's office visits, hospitalization, prescriptions, lab work and behavioral health services. · After allowable income deductions, the annual income is equal to or less than 133% of the Federal Poverty Level (FPL). · There is no limit on the resources or property that may be owned. · An individual may apply at any Department of Economic Security (DES) office, Community Health Center or PCAP (http://www.pcap.cc/) in Pima County. · Call (800) 352-8401 or (602) 542-9935 for additional information. · Ages 19-64. Income 133% Federal Poverty Level (FPL)* Resources No Limit Citizenship & Immigrant Status U.S. Citizen or Qualified Immigrant** Arizona Residency Required Social Security Number Required Special Requirement None Apply at Phone DES, Community Health Center, or www.healthearizonaplus.gov Statewide: (800) 352-8401 Phoenix: (602) 542-9935 * An FPL Chart is located in the tools section of this resource manual. ** For more information on citizenship or qualified alien requirements see the citizenship page located in the tools section at the end of this resource manual. AHCCCS for Families with Children AHCCCS for Families with Children provides medical coverage, such as doctor's office visits, hospitalization, prescriptions, lab work, and behavioral health services to families. To qualify, there must be a child in the household under the age of 18 years (or 19 years if a full-time student). · The annual income limit for this program is 133% of the Federal Poverty Level (FPL). 23 · There is no limit on the resources or property that may be owned. · Deductions that can be subtracted from income before comparing the family's income to the income limit include $90 per month for each person employed and up to $200 per month for child care to enable a family member to work or seek employment. · An individual may apply at any Department of Economic Security (DES) office, Community Health Center, PCAP or Health Care Center. Within Maricopa County, families can visit the Kids Health Link website (http://www.kidshealthlink.org) or call 211 for assistance with applying. · Call (800) 352-8401 or (602) 542-9935 for additional information. Income 133% Federal Poverty Level (FPL)* Income excluded $90 for expenses of employment; Up to $200 for dependent care expenses (depends on age) Resources No limit Citizenship & Immigrant Status U.S. Citizen or Qualified Immigrant** Arizona Residency Required Social Security Number Required for all persons applying Special Requirement Family must include a child deprived of parental support due to absence, disability, unemployment/underemployment, or death of a parent(s). Apply to DES, or Community Health Centers, PCAP in Pima County, or Kids Health Link (www.kidshealthlink.org) in Maricopa County Also, www.healthearizonaplus.gov Statewide: Phone Phoenix: 211 for assistance (800) 352-8401 (DES) (602) 542-9935 (DES) * An FPL Chart is located in the tools section of this resource manual. ** For more information on citizenship requirements see the citizenship page in the tools section of this resource manual. 24 Arizona Long Term Care System (ALTCS) ALTCS is for the elderly (65 and over), blind, or individuals with a disability who need, or are at risk of needing, ongoing services at a nursing facility level of care, including children. However, program participants do not have to currently reside in a nursing home. Many ALTCS participants live in their own homes, assisted living facilities or other community settings and receive needed in-home services. ALTCS participants are also covered for medical care, including doctor's office visits, hospitalization, prescriptions, lab work, and behavioral health services. The income limit for this program is 300% of the Supplemental Security Income Rate (Federal Benefit Rate), which is $2,163 in 2014. Persons with AHCCCS approved income-only trusts may have income in excess of this amount. The resource (cash, bank accounts, stocks, bonds, etc.) limit is $2,000 for a single individual. When the applicant has a spouse who resides in the community, the spouse can retain one-half of the couple's resources, up to a maximum of $113,640 (in 2012; subject to change). Some resources, such as a person's home, vehicle, and irrevocable burial plan generally are not counted toward the resource limit. For specific eligibility requirements, see the chart on the next page. Recently, a new ALTCS Member-Directed Option called Agency with Choice is available. Member directed models or options allow members to have more control over how certain services are provided, including services like attendant care, personal care and housekeeping. Member directed options are available to most ALTCS members who live in their own home. For more information visit the following website: http://azahcccs.gov/shared/SDAC.aspx?ID=memberresources 25 Arizona Long Term Care System (ALTCS) Income 300% of the SSI maximum ($2,163 in 2014) Resources $2,000 Citizenship & Immigrant Status Arizona Residency Social Security Number Apply for and take all required actions to Obtain Other Health Resources U.S. Citizen or Qualified Immigrant** Required Required Required Living Arrangement Must Reside in an AHCCCS Approved and Registered Living Arrangement Apply for Other Cash Benefits such as Social Security or Veterans Benefits Required Special Requirement Apply to Phone Aged, Blind or Disabled Medically eligible – need the level of care provided in a nursing facility. ALTCS Statewide: (800) 654-8713 Phoenix: (602) 417-7000 Any individual or their representative may apply at any ALTCS office. Call (800) 654-8713 or (602) 417-7000 for additional information. For more information on citizenship and qualified alien requirements see the citizenship page in the tools section of this resource manual. 26 Long Term Care Offices Casa Grande 500 North Florence Street Casa Grande, AZ 85222 (520) 421-1500 (855) 277-0260 Chinle Tseyi Shopping Center, Hwy 191 P.O. Box 1942 Chinle, AZ 86503 (928) 674-5439 (888) 800-3804 Cottonwood 1 North Main Street Cottonwood, AZ 86326 (928) 634-8101 (855) 873-0393 Flagstaff 2717 North Fourth Street, Suite 130 Flagstaff, AZ 86004 (928) 527-4104 (800) 540-5042 Globe/Miami Cobre Valle Plaza 2250 Highway 60, Suite H Miami, AZ 85539-9700 (928) 425-3165 (888) 425-3165 519 East Beale Street, Suite 130 Kingman, AZ 86401 2160 N. McCulloch Blvd., Suite 105 Lake Havasu City, AZ 86403 801 E. Jefferson Street, MD 1600 Phoenix, AZ 85034 (928) 753-2828 (888) 300-8348 Prescott 1519 W. Gurley Street, Suite 11 Prescott, AZ 86305 (928) 778-3968 (888) 778-5600 Sierra Vista 820 E Fry Blvd Sierra Vista, AZ 85635 (520) 459-7050 (888) 782-5827 Tucson 1010 N. Finance Center Drive Suite 201 Tucson, AZ 85710 (520) 205-8600 (800) 824-2656 Yuma 3850 W. 16th Street, Suite A Yuma, AZ 85364 (928) 782-0776 (855) 419-6527 Kingman Lake Havasu City Phoenix For a list of ALTCS Contractors, see next page 27 (928) 453-5100 (800) 654-2076 (602) 417-6600 ALTCS Program Contractors County ALTCS Program Toll Free Apache United Healthcare Community Plan-LTC (800) 293-3740 Cochise Bridgeway Health Solutions (866) 475-3129 Coconino United Healthcare Community Plan-LTC (800) 293-3740 Gila Bridgeway Health Solutions (866) 475-3129 Graham Bridgeway Health Solutions (866) 475-3129 Greenlee Bridgeway Health Solutions (866) 475-3129 La Paz United Healthcare Community Plan-LTC (800) 293-3740 Maricopa ALTCS members in Maricopa County may choose among three different program contractors. 1. Mercy Care Plan 2. Bridgeway Health Solutions 3. United Healthcare Community Plan-LTC (602) 263-3000 (800) 624-3879 (866) 475-3129 (800) 293-3740 Mohave United Healthcare Community Plan-LTC (800) 293-3740 Navajo United Healthcare Community Plan-LTC (800) 293-3740 Pima Pinal ALTCS members in Pima County may choose among two different program contractors. 1. Mercy Care Plan 2. United Healthcare Community Plan-LTC (602) 263-3000 (800) 624-3879 (800) 293-3740 Bridgeway Health Solutions (866) 475-3129 Santa Cruz United Healthcare Community Plan-LTC (800) 293-3740 Yavapai United Healthcare Community Plan-LTC (800) 293-3740 Yuma United Healthcare Community Plan-LTC (800) 293-3740 *Native Americans living on a reservation are enrolled with a Tribal Program Contractor or with a Native American Community Health Center. Individuals with a developmental disability are enrolled with the Department of Economic Security, Division of Developmental Disabilities. 28 Breast and Cervical Cancer Treatment Program The Breast and Cervical Cancer Treatment Program provides full AHCCCS health insurance coverage to uninsured women who have been screened by the Department of Health Services’ Well Woman HealthCheck Program (WWHP) or one of the three Native American programs of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) and have been diagnosed as needing active treatment for breast and/or cervical cancer or pre-cancerous cervical lesions. Once the diagnosis is made, they are enrolled in AHCCCS via a streamlined process. To qualify, women should first be screened by either the WWHP or the NBCCEDP, and then referred to AHCCCS’s program based on the screening results. 1. The Well Woman Health Check Programs (WWHP) at ADHS The goal of WWHP (azdhs.gov/hsd/healthcheck/wellwoman/) is to increase women’s access to and utilization of quality screening and diagnostic services. Screening is intended to decrease the number of women requiring treatment for, or dying from, breast and cervical cancer. The program targets women who are at risk due to age, medical conditions, income or inadequate access to medical care. WWHP screening services are available to · Women 18-64 years of age · Women who are uninsured or underinsured · A small number of female Medicare patients who have not purchased Medicare Part B. Services include · Breast and cervical cancer screening for women 40-64 · Cervical cancer screening for women 18-64 · Mammogram · Clinical breast exam · Pap test and pelvic exam · Colposcopy · Fine needle aspiration · Biopsy · HPV Testing · Case Management · Transportation for clinical services Services are delivered via contracts in each county of Arizona. Each contractor designs their service delivery system to meet the needs of their specific county. This allows the contractor to develop networks that can respond to the specific cultural and economic needs of their community. 29 The WWHP County Partners include: Apache, Cochise, Coconino, Graham, Greenlee, La Paz, Maricopa, Mohave, Navajo, Pima, Pinal, Santa Cruz, Yavapai, and Yuma. The program is comprised of coalitions and partnerships, professional development, public education and recruitment, ongoing quality assurance and quality improvement, screening, tracking, follow-up and case management. · For more information please call the toll-free number 1 (877) 257-8502 or visit http://www.wellwomanhealthcheck.org/. 2. Native American programs of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) · For more information about screening through this program, please visit: http://www.cdc.gov/cancer/NBCCEDP/ 3. The Breast and Cervical Cancer Treatment Program at AHCCCS Historically, the Breast Cervical Cancer Treatment Program at AHCCCS was available to those that were referred by the WWHP and met the income requirements. In 2012 this changed. Legislation passed, allowing any qualifying woman regardless of the location of her diagnosis to receive treatment through Medicaid. Income 250% Federal Poverty Level (FPL)* Resources No Limit Citizenship & Immigrant Status U.S. Citizen or Qualified Immigrant** Arizona Residency Required Social Security Number Required Special Requirement Apply to · Under age 65 · Diagnosed as needing treatment for breast or cervical cancer or pre-cancerous cervical lesions. · No other health insurance coverage or Medicare. AHCCCS 30 Phone AHCCCS/Statewide Phoenix ADHS Well Woman HealthCheck (800) 528-0142 (602) 417-5010 (888) 257-8502 * An FPL Chart is located in the tools section of this resource manual. ** For more information on citizenship and qualified immigrant requirements see the citizenship page in the tools section of this resource manual. Family Planning Services Family planning services are covered when provided by physicians or practitioners to members who voluntarily choose to delay or prevent pregnancy. Family planning and family planning extension services include covered medical, surgical, pharmacological, and laboratory benefits. Covered services also include the provision of accurate information and counseling to allow members to make informed decisions about specific family planning methods available. There are no co-payments for family planning services. The following groups are eligible for family planning services: · Eligible AHCCCS/ALTCS members · SOBRA Pregnant Women receive up to 24 months of family planning services after the pregnancy ends if not eligible for other coverage. Eligibility for family planning services is re-determined by the end of the first 12-month period. Women cannot qualify if they have other creditable health coverage during this 24-month period. Services Acute Care, ALTCS, and Fee-for-Service Members SOBRA Family Planning Pregnancy Screening Covered service Covered only when completed prior to provision of long-term contraceptives. Pharmaceuticals Covered service when associated with medical conditions related to family planning or other medical conditions. Covered service only when associated with medical conditions related to family planning. 31 Services Acute Care, ALTCS, and Fee-for-Service Members SOBRA Family Planning Screening and treatment for sexually transmitted diseases (STDs) Both screening and treatment for STDs are covered services. Screening services for STDs are covered but treatment services are not provided through AHCCCS - a referral is made to an agency, which provides low or no cost STD treatment services. Sterilization Services are covered for both male and female members when the requirements specified in this policy for sterilization services are met. Services are covered for female members when the requirements specified in this policy for sterilization are met. Limitations The following are not covered for the purpose of family planning or family planning extension services: · Infertility services including diagnostic testing, treatment services or reversal of surgically induced infertility · Pregnancy termination (abortion) counseling · Pregnancy terminations (abortion) · Hysterectomy · Hysteroscopic tubal sterilization (such as the Essure Micro-Insert). 32 Income There is an income test (150% FPL) at the 12month review, but otherwise income changes do not affect eligibility. Resources N/A Citizenship & Immigrant Status U.S. Citizen or Qualified Immigrant* Arizona Residency Required Social Security Number Required Special Requirement Automatic** eligibility after end of SOBRA Pregnant Woman eligibility No other creditable health coverage Redetermination 12 months Apply to AHCCCS Phone Statewide: (800) 654-8713 Phoenix: (602) 417-7000 * For more information on citizenship and qualified immigrant requirements see the citizenship page in the tools section of this resource manual. ** Some exceptions 33 Federal Emergency Services The AHCCCS Emergency Services Program (FES) provides emergency health care services only on a Fee for Service basis to qualified immigrants and non-citizens who are not eligible for full AHCCCS medical services. These services are provided through the Federal Emergency Services Program. To be eligible for FES services the client must be (1) Pregnant (covers delivery only, no prenatal or postpartum care is provided), (2) a child under the age of 19 or (3) individuals with blindness or another disability and the elderly, or the parent of a child under the age of 19 (1931 category). Income 100% of the FPL Resources N/A Citizenship & Immigrant Status To qualify for this program you do not have to meet the U.S. Citizenship or Qualified Immigrant status requirement that is needed for other programs. Arizona Residency Required Social Security Number Required if individual has or can legally obtain. Special Requirement Apply to Individual or family must meet the requirements of SOBRA, SSI-Cash, SSI Medical Assistance Only or AHCCCS for Families and Children. · DES- children and adults who are not aged and do not have a disability or blindness. · AHCCCS - for aged (65 and older), with blindness or disability. DES Statewide: (800) 352-8401 Phoenix: (602) 542-9935 Phone AHCCCS Statewide: (800) 654-8713 Phoenix: (602) 417-7000 34 Freedom to Work Program This program is for individuals with disabilities between the ages of 16 to 64 whose monthly earned income is up to 250% of the Federal Poverty Level. An applicant must be a U.S. citizen or qualified immigrant and an Arizona resident. There is no limit on resources. Only the individual’s earned income is counted toward the income limit. The individual’s unearned income and the income of other family members living in the home are not counted toward the income limit. An applicant for this program must be working (paying Medicare and Social Security taxes) and ineligible for services under other AHCCCS programs. Members may have to pay a very small monthly premium (up to $35/month). Members can receive either AHCCCS Acute Care or ALTCS services. For more information, call the AHCCCS – Freedom to Work Unit at (602) 417-6677 in the Phoenix area or (800) 654-8713, option 6 in the rest of the state or visit their website page at: http://www.azahcccs.gov/applicants/categories/workingdisabled.aspx Income 250% of the FPL Resources N/A Citizenship & Immigrant Status Required Arizona Residency Required Social Security Number Required Obtaining Other Cash Income such as Social Security and Veterans Benefits Required · Individuals with a disability Special Requirement · Employed – paying Social Security and/or Medicare Taxes Apply to AHCCCS Phone Statewide: (800) 654-8713 Phoenix: (602) 417-7000 35 KidsCare – No New Applications Accepted KidsCare, Arizona's Children's Health Insurance Program (CHIP), provides comprehensive, cost-effective medical coverage for children who have had no health insurance for the last three months. Since January 1, 2010, enrollment into KidsCare has been frozen. Families already enrolled should renew their eligibility and pay their premiums on time so they are not dropped and unable to re-enroll. No new applications are being approved at this time. You may renew for KidsCare at Community Health Centers, the Pima Community Access Program (PCAP), Santa Cruz Health Connection, or through Kids Health Link, or by dialing 211 Premiums A required monthly premium is charged, except to Native Americans. The amount of the premium depends on the income of the family and the number of children they have enrolled in KidsCare. KidsCare premium amounts are available at http://www.azahcccs.gov/applicants/categories/KidsCare.aspx#Premiums KidsCare premium notices are mailed out on the 1st of the month and payments are due by the 15th of the month. AHCCCS/KidsCare will notify recipients of any changes in premium amounts. Premium payments can be mailed, dropped off in person or paid online. · Mail: AHCCCS Health Insurance, PO Box 29144, Phoenix, AZ 85038 – 9144 · Drop Off In Person: AHCCCS Administration, 701 E. Jefferson, Phoenix, Arizona 85034 · Online: Go to www.myahcccs.com to pay premiums online. Coverage ends when premiums are more than one month in arrears (i.e., when payment is a month late). Overdue premiums must be paid before a family can be re-approved for AHCCCS/KidsCare Health Insurance for Parents. 36 Medicare Savings Programs The Medicare Savings Programs provide help with Medicare expenses for people who are age 65 or older, blind, or have a disability. There is no limit on resources, such as cash, bank accounts, stocks, or bonds. Applicants for all programs must be eligible for Medicare Part A hospital insurance. The income limits, special eligibility requirements, and benefits for each program are listed below. Individuals may apply for this program by mail. · Qualified Medicare Beneficiary (QMB) - The monthly income limit for this program is less than or equal to 100% FPL.* If the person qualifies, benefits are payment of the Part A and Part B Medicare premiums, deductibles, coinsurance and co-pays. Individuals eligible for QMB can qualify for other AHCCCS coverage groups and enroll in an AHCCCS health plan. Many of the services for which Medicare does not pay, such as transportation, are covered by AHCCCS. There are some services (for example, chiropractic) that Medicare covers that AHCCCS does not. · Specified Low-Income Medicare Beneficiary (SLMB) - The individual must be receiving or entitled to receive Medicare Part B. Monthly income is more than 100% FPL but less than or equal to 120% FPL*. The SLMB benefit is payment of the Medicare Part B premium. SLMB members cannot enroll in an AHCCCS health plan. · Qualified Individual - 1 (QI-1) - Monthly income is more than 120% FPL but less than or equal to 135% FPL*. The Qualified Individual benefit is payment of the Medicare Part B premium. Qualified Individual members cannot enroll in an AHCCCS health plan. Call (602) 417-5010 or (800) 528-0142 for additional information or to request an application. You may also download an application at www.azahcccs.gov/applicants/application/AcuteCare.aspx?ID=acute or apply for services through Community Health Centers or the Pima Community Access Program in Pima County. *An FPL Chart is located in the tools section of this resource manual. SOBRA AHCCCS provides medical coverage to children under 19 and pregnant women through the SOBRA program. · For children under the age of 1, the monthly income limit is 147% of FPL · For children ages one through five, the monthly income limit is 141% of the FPL 37 · For children age six and older, the monthly income limit is 133% of the FPL · For pregnant women, the monthly income limit is 156% of the FPL · There is no limit on the resources or property that may be owned; however, the income of a child’s parents is counted in determining eligibility. SOBRA for Children (under age 19) Under age 1 Ages 1- 5 6 and older No Limit Income Resources Citizenship & Immigrant Status Arizona Residency Social Security Number 147% Federal Poverty Level* 141% Federal Poverty Level* 133% Federal Poverty Level* U.S. Citizen or Qualified Immigrant ** Required Required DES, Community Health Centers, PCAP in Pima County, or Kids Health Link in Maricopa County. (800) 352-8401 (DES) (602) 542-9935 Apply to Phone SOBRA for Pregnant Women Income Cannot exceed 156% Federal Poverty Level (FPL)* after allowed deductions (limits are higher when more than one baby is expected) Resources No Limit Citizenship & Immigrant Status U.S. Citizen or Qualified Immigrant ** Arizona Residency Social Security Number Required Required Special Requirement Must be pregnant DES, Community Health Centers, PCAP in Pima County, or Kids Health Link in Maricopa County. Apply to Phone Statewide: (800) 352-8401 Phoenix: (602) 542-9935 * An FPL Assistance Chart is located Only in the tools section of this resource manual. Medical (MAO) ** For more information on citizenship requirements see the citizenship page in the tools section of this resource manual The Medical Assistance Only program (SSI/MAO) provides medical coverage for individuals who are age 65 and over, blind or have a disability, but do not receive monthly cash benefits under the Supplemental Security Income (SSI) program. 38 SSI · · · · The income limit is 100% of Federal Poverty Level There is no limit on the resources or property that may be owned Individuals may apply for this program by mail Call (602) 417-5010 in the Phoenix area or (800) 528-0142 from the rest of Arizona for additional information or to request an application. Income 100% Federal Poverty Level (FPL)* Resources No limit Citizenship & Immigrant Status U.S. Citizen or Qualified Immigrant ** Arizona Residency Required Social Security Number Required Special Requirement · · · · Blind Individuals with a disability Age 65 or over Obtain Other Cash Income for which the person might be eligible such as Social Security or Veterans benefits Apply to Social Security Administration - for SSI Cash AHCCCS - for SSI Medical Assistance Only Phone Statewide: (800) 528-0142 Phoenix: (602) 417-5010 *An FPL Chart is located in the tools section of this resource manual. ** For more information on citizen and qualified immigrant requirements see the citizenship page in the tools section of this resource manual. Young Adult Transitional Insurance (YATI) The Young Adult Transitional Insurance program covers young adults between the ages of 18 to 26 who were in Department of Economic Security (DES) foster care when they turned 18 and eligible for Medicaid when turning 18. They receive medical services through AHCCCS. Income No limit Resources Citizenship & Immigrant Status No limit U.S. Citizen or Qualified Immigrant* 39 Arizona Residency Required Social Security Number Required Special Requirement · · Apply to DES Phone Statewide: Phoenix: Under age 26 Child was in DES Foster Care when child became 18 and eligible for Medicaid (800) 352-8401 (602) 542-9935 * For more information on citizenship and qualified immigrant requirements see the citizenship page in the tools section of this resource manual. m. How to Order AHCCCS Applications The following applications can be printed off the AHCCCS website, www.azahcccs.gov: · · Application for AHCCCS health insurance (English and Spanish) Medicare Savings Programs Once you access the AHCCCS website, click on “Apply for AHCCCS” under the Most Popular menu on the left side of the page. You may also click on “AHCCCS Applicants” from the box in the center of the page and then click “Apply for AHCCCS” On the left side of the page. You can also apply online through http://www.healthearizonaplus.gov. Dial 211 to get help from a local assister. In Maricopa County, families can be assisted with an electronic application through Kids Health Link (www.kidshealthlink.org) and in Pima and Santa Cruz Counties through the Your Health Hotline (http://www.pcap.cc/health_hotline.php). n. AHCCCS Contact Information AHCCCS / Main Number (602) 417-4000 Administrative address 801 E. Jefferson Phoenix, AZ 85034 Public Information Office PublicInput@azahcccs.gov Community Partners communitypartners@azahcccs.gov 40 File a Grievance Office of Administrative Legal Services 701 E. Jefferson, MD 6200 Phoenix, Arizona 85034 (602) 417-4232 (800) 654-8713 ext. 74232 Fraud and Abuse 602-417-4045 or 888-487-6686 Member Services (602) 417-4000 (800) 654-8713 Provider Assistance (602) 417-7670 (800) 794-6862 Office of Client Advocate (OCA) (602) 417-4230 (800) 654-8713 ext: 4230 Central Office AHCCCS mail address Enrollment Prior Authorization TDD Telecommunications Device for the Deaf Automated Verification Line (VRU/IVR) Member Verifications (also www.myahcccs.com) AHCCCS Administration KidsCare Office SSI/MAO Office 801 E. Jefferson Phoenix, AZ 85034 (602) 417-7100 (800) 334-5283 (602) 417-4400 (800) 433-0425 (602) 417-4191 (800) 826-5140 (602) 417-7200 (800) 331-5090 (602) 417-7000 (800) 962-6690 801 E. Jefferson Mail Drop 7500 Phoenix, AZ 85034 701 E. Jefferson Mail Drop 3800 Phoenix, AZ 85034 801 E. Jefferson Phoenix, AZ 85034 (602) 417-4000 (800) 654-8713 (602) 417-5437 (877) 764-5437 (602) 417-5010 (800) 528-0142 When calling from within Maricopa County, callers will be restricted from calling 800 o. AHCCCS Enrollment numbers and must dial the local 602Assistance numbers instead. For help with renewals or enrollment, dial 211 to connect with a local assister agency Four Arizona organizations were awarded funding by the federal government in August 2013 to help provide outreach and enrollment assistance for the Health Insurance Marketplace and AHCCCS. They have personnel statewide in a number of organizations and can be located at http://coveraz.org/navigators-and-assisters-map/ or Find Local Help: https://localhelp.healthcare.gov/ Greater Phoenix Urban League, Inc. 602-254-5611 41 Arizona Alliance of Community Health Centers Arizona Board of Regents, University of Arizona Campesinos Sin Fronteras, Inc. 602-218-3900 Several Locations Statewide Tucson Chinese Cultural Center -520-2926900 Pan Asian Community Alliance -520-5120144 928-627-5995 Regional Center for Behavioral Health Additionally, federally qualified Community Health Centers and other community organizations provide assistance enrolling families in AHCCCS programs. Organizations include: Arizona Small Business Association 4600 E Washington St, Suite 340 Phoenix, AZ 85034 (602) 306-4000 AZ Women’s Education & Employment 640 N. First Avenue Phoenix, AZ 85003 (602) 223-4333 4811 E. Grant Road, Suite 262 Tucson, AZ 85712 (520) 327-0222 Asian Pacific Community in Action 6741 N. 7th Street Phoenix, AZ 85014 (602) 265-4598 Empowerment Systems 2066 W. Apache Trail, Suite 116 Apache Junction, AZ 85120 (480) 367-6937 Keogh Health Connection 2375 E Camelback Rd, #250 Phoenix, AZ 85016 (602) 749-4184 Maricopa Clinics: 950 E. Van Buren Avondale, AZ 85323 (623) 344-6800 Desert Mission Community Health Center 9201 N. 5th Street Phoenix, AZ 85020 (602) 331-5779 Homeward Bound 2302 W. Coulter Road Phoenix, AZ 85015-2750 (602) 263-7654 L&A Services, Inc. 3240 E Union Hills Dr, Suite 101 Phoenix, AZ 85050 (602) 996-6010 Maricopa Integrated Health System 2601 E. Roosevelt Street Phoenix, AZ 85008 (602) 344-5011 12428 W. Thunderbird Road El Mirage, AZ 85335 (623) 344-6500 McDowell Healthcare Center 1144 E. McDowell Road Phoenix, AZ 85006 (602) 344-6550 42 7th Avenue FHC 1205 S. 7th Avenue Phoenix, AZ 85007 (602) 344-6600 934 W. Hatcher Phoenix, AZ 85021 (602) 344-6300 811 S. Hamilton Chandler, AZ 85225 (480) 344-6100 5825 E. Calle Guadalupe Guadalupe, AZ 85283 (480) 344-6000 5141 W. LaMar Glendale, AZ 85301 (623) 344-6700 4011 N. 51st Avenue Phoenix, AZ 85031 (623) 344-6900 59 S. Hibbert Street Mesa, AZ 85210 (480) 344-6200 33 W. Tamarisk Phoenix, AZ 85041 (602) 344-6400 Mariposa Community Health Center 1852 N. Mastick Way Nogales, AZ 85621 (520) 281-1550 Phoenix Day/HealthLinks 115 E. Tonto Street Phoenix, AZ 85004 (602) 252-4911 Native Health Center 4520 N. Central Avenue, Suite 620 Phoenix, AZ 85012 (602) 279-5262 Pima Community Access Program (PCAP) 2501 E. Elm Street Tucson, AZ 85716 (520) 694-0418 · UPH Hospital · Juvenile Court · UPH · Kino Teen Center · Wingspan · Pima County Jail 43 St. Elizabeth Health Center (Catholic Charities) 140 W. Speedway Boulevard, Suite 100 Tucson, AZ 85705 (520) 628-7871 Tucson Indian Health Services 7900 South J. Stock Road Tucson, AZ 85746-7012 (520) 295-2405 Facilities: Sells Hospital Santa Rosa Clinic San Xavier Health Clinic 44 IV. Department of Economic Security www.azdes.gov 45 IV. The Arizona Department of Economic Security (DES) a. General Information The Arizona Department of Economic Security (DES) is divided into several different divisions that provide a variety of services such as: · · · · · · · · · · · · · · · · · · · · · · · · Adoption Services Adult Protective Services Cash Assistance Child Protective Services Child Care Assistance Child Support Enforcement Developmental Disabilities Domestic Violence Program Foster Care Foster Grandparent Program Healthy Families Homeless Program JOBS Program Low-Income Home Energy Assistance Program Medical Assistance Migrant Seasonal Farm Workers Outreach Program Nutrition Assistance (formerly the Food Stamp Program) One Stop Career Centers Refugee Resettlement Senior Community Service Employment Program Short Term Crises Services Program Substance Abuse Treatment Tuberculosis Control Program Unemployment Insurance (Extended Benefits Program) The Family Assistance Administration provides financial assistance and/or nutrition assistance to eligible applicants and determines eligibility to receive medical benefits from the Arizona Health Care Cost Containment System (AHCCCS). The Family Assistance Administration establishes eligibility for: · · · · · AHCCCS Medical Assistance Cash Assistance Emergency Food Assistance Program (TEFAP) Nutrition Assistance (formerly the Food Stamp Program) Tuberculosis Control Program 46 DES provides one application that can be used to apply for cash assistance, nutrition assistance and AHCCCS Health Insurance. The application can be downloaded at www.azdes.gov or obtained from your local DES Family Assistance office. Apply for benefits on-line at www.healthearizonaplus.gov. If you need assistance filling out your application, you may call Family Assistance Client Services at (800) 352-8401 or (602) 542-9935 (see next section for more information). The DES Application is one way to apply for AHCCCS Health Insurance Programs. You can also apply by filling out an AHCCCS Application by hand, by downloading one from the internet at Apply for AHCCCS Health Insurance, or visiting your local Community Health Center. You may also receive assistance from the organizations listed on pages 34 and 35. b. DES Family Assistance Offices There are many offices you can go to apply for AHCCCS Health Care and other DES Services, but it is very important that you go to the DES office that serves your zip code. DES Office contact information changes frequently. To find the local office nearest you, please visit https://www.azdes.gov/faa/ziploc.asp and enter your zip code. You can also call: · Statewide: (800) 352-8401 · Phoenix: (602) 542-9935 You can email at: https://www.azdes.gov/forms.aspx?menu=162&ekfrm=5418 47 V. Behavioral Health Resources www.azdhs.gov/bhs/index.htm 48 V. Behavioral Health Resources a. What are Behavioral Health Services? Behavioral Health Services include: · · · · · · · · · Treatment services (i.e., counseling and therapy, assessments, evaluations and screenings); Rehabilitation services (i.e., pre-job training and development, psychosocial rehabilitation living skills training); Medical services (i.e., medication, medical management, laboratory, radiology); Support services (i.e., case management, personal care services, therapeutic foster care, peer support); Crisis intervention services (i.e., crisis stabilization, mobile crisis team); Inpatient services (i.e., hospitalization, residential treatment centers); Residential services (i.e., short-term and long-term residential treatment centers); Behavioral health day programs (i.e., supervised, therapeutic or psychiatric day programs); and Prevention services (i.e., health promotion, referral services, outreach). Behavioral health services are not only for those who feel depressed. Behavioral health services often help people deal with the stresses of everyday life. Below is a list of valuable community resources. Please remember that individuals may also seek help through a clergy member, school teacher, school counselor, coach, nurse, co-worker, or someone else they trust. However, it is critical to seek professional assistance immediately if a person’s behavioral health and their actions are life threatening in any way. For additional referral or other information, please contact: · MIKID at (602) 253-1240 or (800) 356-4543 Arizona only http://www.mikid.org/ Locations in Eagar, Mohave County, Prescott, Phoenix, Tucson and Yuma. · National Alliance on Mental Illness of Arizona at (602) 244-8166, or http://namiaz.org. Several location throughout the state. b. Maricopa County Emergency Services Maricopa Crisis Line (www.crisisnetwork.org) EMPACT Suicide Prevention Center (www.lafronteraarizona.com/index.php?option=c om_wrapper&view=wrapper&Itemid=94) 49 (800) 631-1314 (602) 222-9444 TTY (602) 274-3360 TTY (800) 327-9254 (480) 784-1500 (Maricopa County) (866) 205-5229 (Statewide) (800) SUICIDE (National) St. Luke’s Medical Center (www.stlukesbehavioralhealth.com/services/inpat ient/adult_mental_health) Magellan of Arizona Urgent Psychiatric Care Center (UPC) (magellanofaz.com/for-members/how-to-getcare.aspx) Recovery Innovations Psychiatric Recovery Center (PRC West) Teen Lifeline (teenlifeline.org) TERROS (www.terros.org) Banner Health Services-Behavioral Health (www.bannerhealth.com/Services/Behavioral+He alth/_Behavioral+Health.htm) (480) 736-4949 (Sexual Assault Hotline-Maricopa County) (602) 251-8535 or (800) 821-4193 (602) 416-7600 or (800) 631-1314 Crisis Line (602) 650-1212, then press 2 (602) 248-TEEN (8336) or (800) 248-TEEN 602-685-6000 ext. 1950or (800) 631-1314 (602) 254-HELP (4357) or (800) 254-4357 c. Regional Behavioral Health Authorities (RBHAs) Regional Behavioral Health Authorities (RBHAs, pronounced “reehbahs”) contract with a network of service providers to deliver a full range of behavioral health care services, including prevention programs for adults and children, a full continuum of services for adults with substance abuse and general mental health disorders, adults with serious mental illness and children with serious emotional disturbance. RBHAs are the primary source for behavioral health services provided to individuals enrolled in the State’s insurance programs (e.g. AHCCCS). If an individual is not enrolled in any insurance program, they should contact AHCCCS to become enrolled in a health plan before seeking services at a RBHA, unless it is an emergency or crisis situation. The State is divided into six Geographical Service Areas (GSAs) served by four Regional Behavioral Health Authorities (RBHAs). Mercy Maricopa – Serves Maricopa County. Call (800) 564-5465 Community Partnership of Southern Arizona (CPSA) – Serves Pima County. Call (800) 7719889 or (520) 318-6946. Northern Arizona Behavioral Health Authority (NARBHA) – Serves Mohave, Coconino, Apache, Navajo and Yavapai Counties. Call (800) 640-2123 or (928) 774-7128. Crisis Line: (877) 756-4090 Centpatico Behavioral Health of Arizona – Serves Cochise, Santa Cruz, Pinal, Graham, Greenlee, Gila, Yuma and La Paz Counties. Call (866) 495-6738. Crisis Line: (866)495-6735. 50 d. Tribal RBHAs In addition to RBHAs, the Arizona Department of Health Services (ADHS) has intergovernmental agreements (IGAs) with some of Arizona’s American Indian Tribes to deliver behavioral health services to persons living on the reservation. ADHS currently has agreements with five Arizona Indian Tribes to provide covered behavioral health services for American Indians on reservations. The Tribal RBHAs, or TRBHAs (pronounced “treebahs”), are the primary source for behavioral health services provided to individuals enrolled in the State’s insurance programs or American Indian Health Program (AIHP) and living on a reservation. If the individual is not enrolled in any insurance program, they should contact AHCCCS or AIHP to become enrolled in a health plan before seeking services at a TRBHA, unless it is an emergency or crisis situation. Gila River Indian Community, Navajo Nation, Pascua Yaqui Tribe and the White Mountain Apache Tribe of Arizona each have an agreement with ADHS to deliver both Medicaid and nonMedicaid services. Colorado River Indian Tribe has an agreement for non-Medicaid services only. Services to other Native American Indian Tribes are provided and covered by the local RBHA in which the tribal reservation resides. · Gila River Regional Behavioral Health Authority – (888)-484-8526 ext. 7100, Crisis Line (800) 259-3449 · Navajo Nation Tribal Behavioral Health Authority – (928) 871-6235 · Pascua Yaqui Tribal Behavioral Health Authority – (520) 883-5020 ext 6060 · White Mountain Apache Regional Behavioral Health Authority – (928) 338-4811 or (877) 336-4811 e. Community Based Agencies/Community Crisis Numbers EAST VALLEY (480) 969-4024 A New Leaf Centro de Amistad Inc. (602) 749-4405 or (888) 818-4445 (480) 839-2926 Scottsdale Psychological Associates (480) 922-5440 Jewish Family & Children’s Services (602) 256-0528 Phoenix Interfaith Counseling (480) 317-9868 PSA Behavioral Health Agency (480) 894-1568 Tempe Superstition Mountain Mental Health Center (480) 983-0065 Desert Vista Behavioral Health Center (480) 344-2000 Catholic Charities PHOENIX COMMUNITY-BASED AGENCIES 51 Black Family and Children’s Services (602) 243-1773 (602) 749-4405 or (888) 818-4445 (602) 264-9891 Catholic Charities Family Service Agency Jewish Family & Children’s Services Maricopa Medical Center-Psychiatric Services Native American Connections (602) 256-0528 (602) 344-2000 (602) 254-3247 (602) 248-9247 or (602) 992-7521 (602) 995-1767 (602) 265-8338 main check website for specific clinic number (602) 808-2822 602-685-6000 ext. 1950 Crisis: (602) 222-9444 or (800) 631-1314 (877) 931-9142 Phoenix Interfaith Counseling PSA Behavioral Health Agency Southwest Behavioral Health Lifewell TERROS Community Bridges NATIONAL AGENCIES Depression and Bipolar Support Alliance (800) 826-3632 National Institute of Mental Health Anxiety Disorders The International Foundation for Research and Education on Depression (iFred) Substance Abuse and Mental Health Services Administration (SAMHSA) Anxiety Disorders Association of America (888) ANXIETY (888) 269-4389 (800) 442-HOPE (4673) Español (877) 784-2432 http://store.samhsa.gov/mhlocator (locator by city of services) (800) 969-6642 In Crisis: (800) 273-TALK (8255) (240) 485-1001 National Alliance on Mental Illness Helpline (800) 950-NAMI (8264) National Mental Health Association f. Support Groups Mental Health of America of Arizona has Peer Support Groups that are free and do not require registration for adults 18 years and older. 52 Please call to verify time and place before attending: (480) 994-4407 ext 10 or http://mhaarizona.org/SupportGroups.html NAME Calm Waters DISORDER Bipolar and Depression Caregiver’s For Individuals who Support Group have a loved one with a mental illness Taking Bipolar, Depression Control New Dawn General Mental Health Issues Bipolar Bears Bipolar, Depression Minds Over Matter Anxiety & Depression Being Heard Anxiety, Depression, Schizophrenia, Bipolar, All mental illnesses Eating Disorders Group Obsessive Compulsive Disorders Group Guiding Light Eating Disorders Obsessive Compulsive Disorders Bipolar Depression Support Groups TIME LOCATION Monday Boswell Hospital 6:00–8:00 pm 13180 N. 103rd Drive, Sun City Wednesday Gilbert Community 6:30- 8:00pm Center, 130 N. Oak St., Gilbert Tuesday Deer Valley Church, 6:00-8:00 pm 15220 N. 39th Avenue, Phoenix, AZ 85053, Room 8 Phoenix Tuesday 7:00- PSA Behavioral 9:00 pm Health Agency, 2255 W. Northern Ave., Phoenix Suite B100 Wednesday St. Luke’s Behavioral 7:00-9:00 pm Health Services 1800 E. Van Buren Street, Phoenix 1st and 3rd Granite Reef Senior Wednesday Center 4:00-5:30 pm 1700 N. Granite Reef Road, Scottsdale Wednesday Banner Desert 7:00-9:00 pm Medical Center 1400 S. Dobson Road, Mesa, Mesquite Room nd th 2 &4 Active Forever, Thursday 10799 N. 90th St., 3:15-4:45pm Scottsdale 2nd & 4th Banner Behavioral Thursday Health Center, 7575 7:00-9:00 pm E. Earll Dr., Scottsdale Friday 3:00Via Linda Senior 4:45 pm Center, 10440 E. Via Linda, Conf Rm 8, Scottsdale 53 CONTACT MHA (480) 994-4407 Ext 10 MHA (480) 994-4407 Ext 10 MHA (480) 994-4407 Ext 10 MHA (480) 944-4407 Ext 10 MHA (480) 994-4407 (480) 7676800 MHA (480) 994-4407 MHA (480) 994-4407 Ext 10 NAME Finding Balance New Dawn Hanging on Together Peer Support Group PTSD First Light Calm Waters New Day Hope Support Groups DISORDER TIME LOCATION Bipolar, Depression Friday Arrowhead 4:00-6:00 pm Physicians Bldg 18699 N 67th Ave,, Sierra Room, Glendale Bipolar and Tuesday Presbyterian Service Depression 7:00-9:00 pm Agency 2255 W. Northern Avenue, Phoenix Anxiety, Bipolar, Friday Banner Desert and Depression 7:00-9:00 pm Medical Center 1400 S. Dobson Road, Rosati Education Center. Cholla RoomMesa PTSD Thursday VA 6:00-8:00 pm 650 E Indian School Rd, Phoenix Rm K112 Bipolar & Tuesday Lord of Life Lutheran Depression 5:30-7:30 pm Church 13724 W Meeker Blvd, Sun City West Biplar & Depression Sunday Menke’s Sun City 4:00-6:00pm Room 10307 W Coggins Dr, Sun City Depression Thursday West Valley Center 5:30-7:30pm for Spiritual Living, 9745 W. Peoria Ave., Peoria Depression Monday Christ Evangelical 5:30-7:30pm Lutheran Church, 918 S. Litchfield Road, Goodyear, Classroom C 54 CONTACT MHA (480) 994-4407 Ext 10 PSA (602) 995-1767 MHA (480) 994-4407 Ext 10 MHA (480) 994-4407 Ext 10 MHA (480) 994-4407 Ext 10 MHA (480) 994-4407 Ext 10 MHA (480) 994-4407 Ext 10 MHA (480) 994-4407 Ext 10 VI. Community Health Centers www.aachc.org 55 VI. Community Health Centers The Community Health Centers (CHCs) and the Sliding Fee Community Clinics provide “Primary Care Services” to any person regardless of whether they have insurance, Medicaid, or no insurance. In addition to the list provided below, visit the following website for a current list of community health centers and sliding-fee-schedule clinics: www.azdhs.gov/hsd/slidingfees/locations.htm a. What is Primary Care? Primary Care services can be defined as: “A basic level of care usually given by doctors who work with general and family medicine, internal medicine, pregnant women, and children (pediatricians). A nurse practitioner, a state licensed registered nurse with special training, can also provide this basic level of health care.” Your primary care doctor is the doctor you see first for most health problems. He or she makes sure that you get the care that you need to keep you healthy. He or she also may talk with other doctors and health care providers about your care and refer you to them. In many health plans, you must see your primary care doctor before you see any other health care provider. b. General Information About CHCs CHCs are public, not-for-profit organizations established by a federal law in the 1960’s to treat and provide primary care to all patients regardless of ability to pay or lack of insurance. CHCs are also known as Federally Qualified Health Centers (FQHCs). FQHCs are the single largest primary health care system in the United States. They provide access to comprehensive patient-centered healthcare in medically underserved urban and rural areas. Their integrated healthcare system includes a continuum of primary healthcare services including: pharmacies, labs, X-ray, dental services, treatment of chronic diseases (i.e. asthma, diabetes, heart disease, etc.) and behavioral health services. They also provide transportation services, Women Infant and Children (WIC) and a number of other support services. The clinics listed in this section (see chart below) provide primary care services to their local communities. They provide services to any community member and discounted fee services to Arizona residents who are uninsured, ineligible for other insurance programs, and have incomes below 200% of the Federal Poverty Level. They also screen clients for publicly funded health insurance programs such as AHCCCS and KidsCare. 56 How to Enroll Patients should make an appointment to see a provider at one of the contractor’s clinics. Some clinics have the capacity to take “walk-ins.” The patient must bring proof of the previous month’s income (pay stub, letter from employer, etc.) and proof of residency (State ID, license, utility bills, etc.) for verification. Check with the clinic to verify what documents are required to determine eligibility for services. The clinic will determine if the patient is eligible, and if so, they will be automatically enrolled in the program on site, and may receive covered services on that visit. Payments Eligible patients will pay for the services they receive on a sliding fee scale basis. A sliding fee scale shows how much a person will have to pay for the care they receive at the clinic. The scale is a discounted rate for the cost of the service based on how much money the person earns. Patients are asked to pay only for the services they receive at the clinic at the time the services were received. Sliding fee scales AND services may differ from clinic to clinic. Below is a sample* sliding fee scale: Income Range 0%-100% FPL 101%-150% FPL 151%-200%FPL Above 200% FPL Sliding Fee Scale Patient pays 25% of service cost Patient pays 50% of service cost Patient pays 75% of service cost Patient pays full cost of service *NOTE: This scale is an example and may differ from clinic to clinic. Services Offered* · · · Medical Diagnosis and Treatment · Tracking and Follow-up Services Physical Exams · Emergency Stabilization Early Detection of Illness and · Non-emergency Transportation Disease Services · Prenatal Care Services · Urgent Care Services · Diagnostic Laboratory, Radiology · Nutrition Counseling and Imaging Services · WIC · Pharmacy Services · Case Management · Preventive Health Services · Patient Transportation for Appointments · Dental and Restorative Services · Outreach Services · Integrated Behavioral Health Care · Health Education and Referral *Not all clinics on the next page provide the full list of services above. 57 c. Community Health Center Locations City 1 2 3 4 5 AJO Desert Senita Community Health Center AMADO United Community Health Center Amado Clinic ARIVACA United Community Health Center Arivaca Clinic ASH FORK AVONDALE 6 AVONDALE 7 BISBEE BLACK CANYON CITY 8 9 11 BUCKEYE BULLHEAD CITY BULLHEAD CITY 12 CASA GRANDE 13 CASA GRANDE 10 14 Organization CHANDLER North Country HealthCare - Ash Fork Clinic Adelante Healthcare Avondale-OB/GYN Address Zip Phone 410 N. Malacate Street 853212219 520-387-5651 28720 S Nogales Hwy 856459997 520-407-5510 17388 W. 3rd Street 856010233 520-407-5500 112 Park Avenue 86320 928-637-2305 3400 N Dysart Rd, Ste. F-121 85392 877-809-5092 853231506 623-344-6800 85603 520-432-3309 Avondale Family Health Center Chiricahua Community Health Center, Inc.Bisbee Clinic 950 E. Van Buren Street Randy C. Hancock, D.O. Family Practice 34601 S. Phyllis Street 85324 623-374-0200 Adelante Healthcare Buckeye North Country HealthCare-Bullhead City Clinic 306 E. Monroe Avenue 853262706 877-809-5092 2585 S Miracle Mile, Suite 116 86442 928-704-1221 River Cities Community Clinic Sun Life Family Health Center, Inc.-Casa Grande Sun Life Family Health Center, Inc.-Center for Women & Children 813 Hancock Rd, Suite 2 86442 928-704-9700 865 N. Arizola Road 85222 520-836-3446 1856 E Florence Blvd 85222 520-381-0380 811 S. Hamilton Street 852256308 480-344-6100 520-723-9131 Chandler Family Health Center 108 Arizona Street 15 COOLIDGE Sun Life Family Health Center, Inc.-Coolidge 1284 N. Arizona Blvd 85128 16 COTTONWOOD Community Health Center of Yavapai 86326 928-639-8132 1100 F Avenue 856071920 520-364-3285 815 15th Street 85607 520-364-5437 227 Main Street 85534 928-359-1380 12428 W. Thunderbird Road 853353113 623-344-6500 10566 N. US Highway 191 856109021 520-642-2222 85131 520-466-7883 2920 N 4 Street 86004 928-213-6100 928-773-1245 17 DOUGLAS 18 DOUGLAS 19 20 21 22 23 DUNCAN Chiricahua Community Health Centers, Inc.Jennifer “Ginger” Ryan Clinic Chiricahua Community Health Centers, Inc.15th Street Pediatric Center of Excellence Duncan Community Health Center EL MIRAGE El Mirage Family Health Center ELFRIDA Chiricahua Community Health Centers, Inc.Cliff Whetten Clinic ELOY FLAGSTAFF Sun Life Family Health Center, Inc.-Eloy North Country HealthCare Flagstaff Clinic 51 Brian Mickelsen Parkway 205 N Stuart Blvd th 24 FLAGSTAFF NACA Family Health Center 1500 E Cedar Ave, Suite 26 86004 25 FLAGSTAFF Sacred Peaks Health Center 3480 E Route 66 86004 928-863-7333 500 S. Central Avenue 852322945 520-866-7319 928-643-6215 26 FLORENCE Pinal County Division of Public Health 27 FREDONIA Fredonia Community Health Center 100 E. Wood Hill Road 86022 28 GANADO Sage Memorial Hospital Route 264 & Jct. 191 86505 928-755-4500 100 N. Gila Bend 85337 877-809-5092 623-344-6700 928-402-0491 29 GILA BEND Adelante Healthcare Gila Bend 30 GLENDALE Glendale Family Health Center 5141 W. LaMar 85301 31 GLOBE Canyonlands Healthcare-Globe 5860 South Hospital Dr, Ste 102 85501 58 City 32 33 34 34 35 36 37 38 Organization Mountain Park Community Health CenterGOODYEAR Goodyear GRAND North Country HealthCare-Grand Canyon CANYON Clinic United Community Health Center at Presidio GREEN VALLEY Point United Community Health Center Continental GREEN VALLEY Family Medical Center United Community Health Center Continental GREEN VALLEY Pediatrics GUADALUPE GUADALUPE HOLBROOK Guadalupe Family Health Center Guadalupe Health North Country HealthCare-Holbrook Clinic Address Zip Phone 140 N Litchfield Rd, Suite 200 85338 602-243-7277 1 Clinic Road 86023 928-638-2551 275 W Continental Rd Suite 141 85622 520-407-5400 1260 S Campbell Road 85614 520-407-5900 1260 S Campbell Road 85614 520-407-5800 5825 E. Calie Guadalupe 85283 480-344-6000 852832529 480-768-2025 2109 Navajo Blvd 86025 928-524-2851 Chilchinbeto Chapter House Complex 86033 928-697-8154 9405 S. Avenida del Yaqui 39 KAYENTA Canyonlands Healthcare-Chilchinbeto Clinic 40 KINGMAN LAKE HAVASU CITY North Country HealthCare-Kingman Clinic 1510 Stockton Hill Rd North Country HealthCare-Lake Havasu City Clinic 2090 N Smoketree Ave 86401 928-753-1177 86403 928-854-1800 Canyonlands Healthcare-Beaver Dam 3272 E Rio Virgin Rd 86432 928-347-5971 520-682-4111 41 42 LITTLEFIELD 43 MARANA MHC Healthcare-Main 13395 N Marana Main Street 85653 44 MARANA 13395 N Marana Main St. #B 85653 520-682-1091 45 MARANA 13395 N Marana Main Street 85653 520-797-0011 46 MARANA MHC Healthcare-Behavioral Health Services MHC Healthcare-Obstetrics & Women’s Health MHC Healthcare.-Teen Wellness High School 12000 W Emigh Rd 85653 520-616-6400 Sun Life Family Health Center, Inc.-Maricopa 44765 Hathaway Avenue 85139 520-568-2245 Adelante Healthcare Mesa 1705 W Main Street 85201 877-809-5092 480-344-6200 47 48 MARICOPA MESA 49 MESA Mesa Family Health Center 59 S. Hibbert 85210 37 MORENCI Morenci Healthcare Center Coronado Blvd & Burro Alley 85540 928-865-4511 38 NOGALES Carondelet Holy Cross Hospital 1171 W. Target Range Road 856212497 520-285-3000 Mariposa Community Health Center, Inc.Nogales 1852 N Mastick Way 856211061 520-281-1550 Sun Life Family Health Center, Inc.-Oracle 1870 W American Way 85623 520-896-2092 467 Vista Avenue 86040 928-645-8123 928-645-1700 *39* 50 NOGALES 51 52 ORACLE PAGE Lake Powell Medical Center 53 PAGE Canyonlands Urgent Care (Sat hours only) 440 North Navajo Drive 85040 54 PATAGONIA Patagonia Family Health Center 101 Taylor Street 85624 520-281-1550 850073904 602-344-6600 85007 602-344-6655 877-809-5092 55 56 PHOENIX PHOENIX 7th Avenue Family Health Center th 7 Avenue Walk In Clinic 1205 S 7th Avenue th 1201 S 7 Avenue 57 PHOENIX Adelante Healthcare Phoenix 7725 N 43 Ave, Suite 510 85051 58 PHOENIX Arizona Children’s Center 2601 East Roosevelt Street 85008 602-344-5051 9201 N 5 St 85020 602-331-5779 2525 E Roosevelt Street 85008 602-344-1015 220 S. 12th Ave 85007 602-372-2105 1144 E. McDowell Road #300 85006 602-344-6550 635 E. Baseline Road 85042 602-243-7277 690 N. Cofco Center Court #230 85008 602-243-7277 4011 N. 51st Avenue 85031 623-344-6900 59 PHOENIX Desert Mission Community Health Center 60 PHOENIX 61 PHOENIX Comprehensive HealthCare Center Maricopa County Health Care for the Homeless 62 PHOENIX McDowell HealthCare Center 63 PHOENIX 64 PHOENIX 65 PHOENIX Mountain Park Health Center-Baseline Mountain Park Health Center-East Phoenix Maryvale Family Health Center (Gyn & Peds Only) rd th 59 City 66 PHOENIX Organization Mountain Park Health Center-Maryvale Address Zip Phone 6601 W Thomas 85033 602-243-7277 602-279-5262 67 PHOENIX Native Health: Central 4520 N. Central Avenue, Ste 620 85012 68 PHOENIX NHW: Community Health Center West 2423 W. Dunlap Avenue, Suite 140 85021 602-279-5351 1124 North Third Street, Suite 1 85004 602-523-9275 15833 North 29 Street 85032 480-882-4545 33 W. Tamarisk Avenue 850412422 602-344-6400 934 W Hatcher 85021 602-344-6300 420 W. Watkins Road 85002 602-261-6868 th 85014 602-258-6797 st 602-523-9312 69 70 71 PHOENIX PHOENIX PHOENIX 72 PHOENIX 73 PHOENIX 74 PHOENIX NP Healthcare-Grace Palomino Health Center South Central Family Health Center Sunnyslope Family Health Center St. Vincent de Paul Free Medical/Dental Clinic Valle Del Sol Pediatric Care th 3807 North 7 Street 75 PHOENIX Valle Del Sol Family & Adult Care 1209 South 1 Ave 85003 76 PHOENIX Wesley Community & Health Center 1300 S 10th St 85034 602-257-4323 Community Health Center of Yavapai 1090 Commerce Drive 86305 928-583-1000 Community Health Center of Yavapai Mariposa Community Health Center at Rio Rico 3212 N. Windsong Drive 2nd Floor 86314 928-583-1000 1103 Circulo Mercado 85648 520-281-1550 85546 928-428-1500 85629 520-576-5770 928-627-3822 85349 928-726-5950 1896 E Babbit Lane 85349 928-722-6112 Rio Vista Estates Lot 24 86512 23 McNab Pkwy 85631 520-385-2234 480-882-4545 77 78 PRESCOTT PRESCOTT VALLEY 79 RIO RICO th 80 SAFFORD 81 SAHUARITA 82 SAN LUIS Canyonlands Healthcare Safford 2016 W 16 St United Community Health Center at Sahuarita Heights 2875 E Sahuarita Road 815 E. Juan Sanchez Boulevard (Internal Med and Pediatrics) 815 E. Juan Sanchez Blvd (Women’s Sunset Community Health Center-San Luis Health) 83 SAN LUIS San Luis Walk In-Clinic, Inc. 84 SANDERS 85 SAN MANUEL Sanders Clinic Sun Life Family Health Center, Inc.-San Manuel 928-688-3903 86 SCOTTSDALE Heuser Family Medicine Center 7301 E Second St, Ste 210 85251 87 SELIGMAN North Country HealthCare – Seligman Clinic 22585 West Oak Street 86337 928-422-4017 2650 E Show Low Lake Rd, Suite 1 85901 928-537-4300 4655A N Commerce Drive 85635 520-459-3011 115 N. Somerton Avenue 85350 928-627-2051 214 W Main Street 85350 928-627-1120 488 S Mountain Ave 85938 928-333-0127 625 North 13 West 85936 928-337-3705 259A West Highway 264 86511 928-810-3800 15351 West Bell rd 85374 877-809-5092 1492 S Mill Avenue, Suite 312 85281 602-243-7277 167 North Main St 86045 928-283-2501 2030 E. Broadway, Suite 214 85719 520-990-3984 5979 E Grant Road, Suite 107 85712 520-670-3909 225 W Irvington Rd 85706 520-670-3909 101 W Irvington Rd, Bldg 10 85714 520-670-3909 88 SHOW LOW 89 SIERRA VISTA 90 SOMERTON 91 SOMERTON 92 93 North Country HealthCare-Show Low Clinic Chiricahua Community Health Centers, Inc.Sierra Vista Mobile Medical Clinic Sunset Community Health Center-Somerton Regional Center for Border Health, Inc. North Country HealthCare-Round Valley SPRINGERVILLE Clinic ST. JOHNS North Country HealthCare-St. Johns Clinic 94 ST. MICHAELS 95 SURPRISE St. Michaels Clinic Adelante Healthcare- Surprise Comprehensive 96 TEMPE Mountain Park Health Center-Tempe 97 TUBA CITY 98 TUCSON 99 TUCSON 100 TUCSON 101 TUCSON Tuba City Regional Health Care Dequenesh Community Clinic (Women’s Health only) El Rio Community Health Center-Birth & Women’s Center El Rio Community Health Center-OB/GYN Associates El Rio Community Health Center-El Pueblo Clinic th 60 City 102 TUCSON 103 TUCSON 104 TUCSON 105 TUCSON 106 TUCSON 107 TUCSON 108 TUCSON 109 TUCSON 110 TUCSON Organization El Rio Community Health Center-Broadway Clinic (Homeless & BH) Address Zip Phone 1101 E Broadway Blvd 85719 520-670-3909 El Rio Community Health Center-Congress El Rio Community Health Center-Northwest Medical Clinic El Rio Community Health Center-Southeast Clinic 839 W. Congress Street 85745 520-670-3909 320 W Prince Rd 85705 520-670-3909 6950 E Golf Links 85730 520-670-3909 El Rio Community Health Center Southwest Internal Medicine Clinic El Rio Community Health Center-Pascua Yaqui Clinic El Rio Community Health Center- Special Immunology Associates El Rio Community Health Center-Summit View Clinic El Rio Community Health Center-Sunnyside Teen Clinic 1510 W. Commerce Court (Internal) 1500 W Commerce Court (Peds) 857466015 520-670-3909 7474 S. Camino de Oeste 85746 520-670-3909 1701 W St. Mary’s Road 85745 520-670-3909 1900 E Summit St 85706 520-670-3909 1725 E Bilby Rd 85706 520-670-3909 857057698 520-628-7871 111 TUCSON St. Elizabeth Health Center 140 W. Speedway Blvd, Suite 100 112 TUCSON Marana Health Center, Inc.-Clinica del Alma Marana Health Center, Inc.-East Side Health Center Marana Health Center, Inc.-Ellie Towne Health Center Marana Health Center, Inc.-Flowing Wells Family Health Center Marana Health Center, Inc.-Freedom Park Health Center 3690 South Park Ave 85713 520-616-6760 8181 East Irvington Rd 85730 520-574-1551 1670 W Ruthrauff Rd 85705 520-616-6797 1323 West Prince Rd 85705 520-887-0800 5000 East 29th Street 85711 520-790-8500 435 East Glenn Road 85705 520-696-6969 12635 W Rudasill Rd 85743 520-682-3777 2055 W Hospital Drive, Suite 115 85704 520-797-0011 15631 N Oracle Rd, Suite 141 85739 520-825-6763 2355 N Wyatt Dr., Ste 101 520-616-4948 2202 West Anklam Rd 85709 520-616-6790 899 N Wilmot Road, Building B 85711 520-290-1100 15921 W. Ajo Way 85735 520-407-5700 125 VAIL MHC-.-Primary Care Marana Health Center, Inc.-West Side Health Center MHC Healthcare-Wilmot Family Health Center United Community Health Center at Three Points Clinic United Community Health Center at Old Vail Middle School 85712 13299 E Colossal Cave Road 85641 520-762-5200 126 WELLTON Sunset Community Health Center-Wellton 10425 Williams Street 85356 928-785-3256 877-809-5092 113 TUCSON 114 TUCSON 115 TUCSON 116 TUCSON 117 TUCSON 118 TUCSON 119 TUCSON 120 TUCSON 121 TUCSON 122 TUCSON 123 TUCSON 124 TUCSON Marana Health Ctr, Inc.-Keeling Health Ctr Marana Health Center, Inc.-Ortiz Community Health Center Marana Health Center, Inc.-MHC Obstetrics and Women’s Health Marana Health Center, Inc.-Santa Catalina Health Center 127 WICKENBURG Adelante Healthcare Wickenburg 811 N. Tegner St., # 113 85390 128 WILLIAMS North Country HealthCare-Williams Clinic 301 S 7th Street 86046 928-635-4441 928-289-2000 129 WINSLOW North Country HealthCare-– Winslow Clinic 620 W. Lee Street 86047 130 YUMA Sunset Community Health Center – Yuma 2060 W. 24th St. 85364 928-344-4216 2060 W. 24 Street Suite B 85364 928-726-5950 2060 W 24th St. 85364 928-344-5112 131 YUMA 132 YUMA Sunset Women's Health Group Sunset Community Health Center-Yuma Pediatrics th 61 VII. Dental Health http://www.azdhs.gov/phs/owch/oralhealth/index.htm 62 VII. Dental Health Oral and dental health services are offered through a wide variety of community programs and agencies, including AHCCCS. For children enrolled in AHCCCS, dental services are provided primarily through contracted health plans and their dental provider networks. The member services department of individual health plans should be contacted for specific questions concerning AHCCCS dental services. Plans on the health insurance Marketplace are not required to include dental coverage because stand alone dental plans can be purchased separately. Marketplace consumers should pay close attention to whether a plan includes dental coverage if they would like to use those services. Stand alone dental plans are not eligible for subsidies. Other dental resources are below. a. Arizona Dental Association Arizona Dental Association www.azda.org Statewide (800) 866-2732 (480) 344-5777 Programs · · · Discounted Dental Services o These providers offer discounted dental care to families. o Discounted services are provided on a sliding scale based on ability to pay. o A complete list of providers and phone numbers can be obtained and downloaded at the following web address: http://www.azda.org/docs/default-source/important-documents/community-dentalclinics.pdf Donated Dental Services o This program provides free non urgent dental services to those who qualify. o Seniors, individuals with a disability, and medically compromised individuals without financial resources may be able to qualify. o Individuals must fall within 100% of FPL, be without dental insurance or financial resources and provide verification of income. o Application is required and is located at o Call (480) 850-1474 or (866) 340-4337 to see if you qualify. Find a Dentist o Log onto www.azda.org to locate a dentist in your community. First, click on Public Resources, and then click on Find Arizona Dentist. Your search may include specific criteria like, language, special needs, financing, or phobias. 63 b. Arizona Dental Sealant Program · Dental sealants are tooth colored coatings that are painted on the biting surfaces of the back teeth. Sealants block food and decay-causing bacteria from entering the narrow grooves of the teeth where decay is most likely to occur. They are a highly effective means of preventing tooth decay. · Program participants receive sealants on their permanent molars using the Office of Oral Health’s portable dental equipment that is set up at the school site. Eligibility o 2nd and 6th grade children without private dental insurance who have erupted, non-restored, non-decayed first and/or second permanent molars. o Public and charter schools with a high level of free and reduced school meal program participation may apply. o Parental permission is required · · For more information talk to your school administrators or call the Arizona Department of Health Services Office of Oral Health at (602) 542-1866 or visit c. Arizona School-Based Fluoride Mouthrinse Program · Fluoride is recognized as an effective agent in the control of dental decay. The most cost-effective method for the reduction of tooth decay is obtaining systemic fluoride through community water fluoridation. However, not all Arizona communities have drinking water with the optimal fluoride levels · The program is an effective alternative to systemic fluoride in the reduction of tooth decay as demonstrated by research conducted over the past 15 years. Fluoride mouth rinsing is a proven and effective method in reducing tooth decay up to 31%. Eligibility o Schools in areas with sub-optimal fluoride levels in the community drinking water and o That have over 50% student participation in the free and reduced school lunch program are encouraged to participate in this program. · · For more information talk to your school administrators or call the Arizona Department of Health Services Office of Oral Health at (602) 542-1866 or visit http://www.azdhs.gov/phs/owch/ooh/schools/fluoride.htm d. Arizona Fluoride Varnish Program · Several regions of Arizona have Fluoride Varnish Programs funded by First Things First (FTF) (http://www.azftf.gov). The Fluoride varnish works to strengthen teeth and help 64 prevent tooth decay. The program provides oral screenings, helpful oral health education and fluoride varnish from the first tooth through age 5. · · · The screening and fluoride varnish takes less than 5 minutes and the child can eat and drink following the fluoride application. Eligibility o Must live in the areas of the state where the program is offered o Child must be 5 or under. For more information visit http://www.azftf.gov and enter your zip code to determine your FTF region. Then check the regions page to see if the program is available. In the following regions, program information is available: o Select Maricopa County regions: http://www.maricopa.gov/publichealth/Programs/Oral/firstteeth.aspx o Yuma: http://extension.arizona.edu/yuma/first-smiles or call 928-726-3904 o Cochise County: http://extension.arizona.edu/cochise/first-smiles or call 520458-8278 o Graham and Greenlee Counties: call 928-428-2611 e. Other Organizations · Boys and Girls Club of Metro Phoenix o Dave Pratt Dental Clinic provides full service dental care to children who cannot afford it. o For more information call (602) 271-9961 or visit http://www.bgcmp.org/dental.htm · Arizona School of Dentistry and Oral Health Clinic o The Arizona School of Dentistry and Oral Health is located at A.T. Still University of Health Sciences. o Two Clinics provide dental and oral health care services on a sliding-fee scale. Locations o For more information please call (480) 248-8100 or visit www.atsudental.com/home/ · Northern Arizona University o The NAU Dental Hygiene Clinic provides comprehensive dental hygiene and preventive services to students and the public. o Fees for services are reasonable and depend on individual needs. · For more information call (928) 523-3500 or visit their website at www.nau.edu/chhs/ddh/ · John C. Lincoln Desert Mission Children’s Dental Clinic o Serves ages 4-20 with no dental insurance and AHCCCS, located in Phoenix. Fees are based on a sliding scale rate. 65 o For more information please call (602) 870-6363, or visit the website: http://www.jcl.com/desert-mission/childrens-dental-clinic · Central Arizona Shelter Services Dental Clinic o The CASS Dental Clinic's priority is to provide quality, comprehensive dental care to children, families and adults within the homeless population. o The clinic offers the following programs: Children's Dental Clinic Program, Homeless Veteran's Dental Program, CASS School of Dental Assisting, and the Children's Dental Clinic serving the Murphy Community. o Murphy Kids Dental Clinic is an on-site, no-cost, school-based, comprehensive dental home for the children who live in the Murphy School District in south Phoenix. The Murphy Clinic eliminates barriers to services and provides timely and quality dental care to each of the 2,200 children enrolled in the district’s four elementary schools. o 230 South 12th Avenue Phoenix, AZ 85007 602-256-6945 x 3125 o http://www.cassdentalclinic.org/ · Gompers Dental Center o Provides services for those with special needs. Accepts many private insurance plans as well as affordable payment options for uninsured. o (602) 336-0061 x 159 f. Dental Treatment Referral List Call individual clinics for more information on hours, fees, services, and eligibility requirements. See Chart below for details about Clinic locations. Agency Maricopa County: · Maricopa Integrated Health System (MIHS) · · · Address and Phone Comprehensive Healthcare Center 2525 E. Roosevelt St, Phoenix (602) 344-1015 Avondale Family Health Center 950 E. Van Buren, Avondale (623) 344-6800 Chandler Family Health Center 811 S. Hamilton, Chandler (480) 344-6100 El Mirage Family Health Center 12428 W. Thunderbird, El Mirage (623) 344-6500 66 Other Service benefits depend on AHCCCS Plan Some emergency services may be available Agency · · · · · · · · Address and Phone Glendale Family Health Center 5141 W. Lamar, Glendale (623) 344-6700 Guadalupe Family Health Center 5825 E. Calle Guadalupe (480) 344-6000 Maryvale Family Health Center 4011 N. 51st Avenue, Phoenix (623) 344-6900 McDowell Healthcare Center 1144 E. McDowell Road, #300 Phoenix (602) 344-6550 Mesa Family Health Center 59 S. Hibbert, Mesa (480) 344-6200 7th Avenue Family Health Center 1205 S. 7th Avenue, Phoenix (602) 344-6600 South Central Family Health Center 33 W. Tamarisk, Phoenix (602) 344-6400 Sunnyslope Family Health Center 934 W. Hatcher, Phoenix (602) 344-6300 Other · Statewide: Arizona State AHCCCS Urgent Care Center 1201 S. 7th Avenue, Phoenix (602) 344-6650 Enrollment: (602) 417-7100 or (800) 334-5283 Provider Assistance: (602) 417-7670 or (800) 794-6862 Statewide: Children’s Rehabilitative Services Children’s Clinics for Rehabilitative Services (866) 275-5776 TTY# (800) 367-8939 or 711 Metro Phoenix Region: (602) 914-1520 (855) 598-1871 Southern Region: (520) 324-5437 (800) 231-8261 67 Variety of dental services available Serving children with cleft lip/palate, birth defects and related problems Agency Statewide: KidsCare Phoenix: Lincoln Children’s Dental Clinic Mountain Park Health Center Native Health Central Phoenix College Dental Hygiene Clinic Phoenix Indian Medical Center Dental Clinic Rio Salado College School of Dental Hygiene St. Vincent de Paul Dental Clinic Veteran’s Administration Maricopa County – Department of Public Health Services Other Communities: Arizona School of Dentistry and Oral Health Dental Clinic Arizona School of Dentistry and Oral Health Dental Care West Desert Senita Dental Center Chiricahua Community Health Centers, Inc. (Mobil Dental) Address and Phone Northern Region: (928) 773-2054 (800) 232-1018 Southwestern Region: (928) 336-7095 (800) 837-7309 (877) 764-5437 or (602) 417-5437 9229 N. 4th Street, Phoenix (602) 870-6363 635 E. Baseline, Phoenix (602) 243-7277 4520 N. Central Avenue, 3rd Floor, Suite 620, Phoenix (602) 279-5262 1202 W. Thomas Road, Phoenix (602) 285-7323 4212 N. 16th Street, Phoenix (602) 263-1592 2323 W. 14th Street, Tempe* (480) 517-8000 *opens Summer 2013 420 W. Watkins, Phoenix (602) 261-6868 Other For children under age 19 Sliding-fee scale Prevention Services Native Americans Prevention Services Priority for working people and their families 650 E. Indian School Road, Phoenix (602) 222-6550 (888) 214-7264 220 S. 12th Avenue (602) 372-2100 Eligible Veterans 5855 E. Still Circle, Mesa (480) 248-8100 20325 North 51st Avenue, Unit 156 Glendale, AZ 85308 (623) 251-4700 410 Malacate Street Building B, Ajo (520) 387-4500 10566 Highway 191, Elfrida (520) 642-2222 Sliding-fee scale 68 Homeless Sliding-fee scale Clinics in Douglas and Elfrida Agency Community Health Center of Yavapai/YCCHS Address and Phone 3212 North Windsong Drive Second Floor, Prescott Valley (928) 771-3377 Sun Life Family Health Center, 865 N. Arizola Road, Casa Grande Inc. (520) 836-3446 United Community Health Center, Inc. North Country Healthcare Mariposa Community Health Center, Inc. Adelante Healthcare El Rio Community Health Center St. Elizabeth Health Center Pima Community College Dental Hygiene Clinic MHC Healthcare NOAH Dental Clinic 81 W. Esperanza Boulevard Suite 201, Green Valley (520) 407-5600 2929 N 4ht Street, Flagstaff (928) 213-6151 1852 N. Mastick Way, Nogales (520) 281-1550 306 East Monroe Ave, Buckeye (623) 386-1630 15317 W Bell Rd, suite 108, Surprise (623) 544-5189 Northwest Dental 4009 North Flowing Wells Rd, Tucson (520) 670-3909 Southwest Dental 1530 West Commerce Court, Tucson (520) 670-3909 140 W. Speedway Suite 100Tucson (520) 628-7871 2202 W. Anklam Road Tucson (520) 206-6090 13395 N Marana Main St Marana (520) 616-6200 Main Office: 6535 E Osborn Road Scottsdale (480) 882-4545 Mohave Community College Dental Hygiene School 3400 Highway 95 Bullhead City(928) 704-7788 Coconino County Public 304 S Humphreys 69 Other Clinic in Prescott Clinics in Casa Grande, San Manuel, Coolidge, Eloy, and Maricopa Clinics in Arivaca, Green Valley, and Tucson Dental Clinics in Ash Fork, Winslow, and Flagstaff locations Clinics in Nogales and Patagonia Clinics in Surprise, Buckeye, Queen Creek, Gila Bend, and Wickenburg Dental offered in Central, Northwest and Southwest locations in Tucson Tucson Tucson Marana Phoenix Scottsdale Cleaning & exam only Age 3 and older Set fee schedule Uninsured under Agency Health Services District Dental Clinic NAU Homebound Address and Phone Flagstaff (928) 679-7825 Flagstaff (928) 523-6709 NACA Family Health Center Flagstaff (928) 773-1245 Sunset Community Health Center (928) 785-8008 Wellton (928) 627-8806 Somerton (928) 627-8584 San Luis (800) 558-3487 EDS Dental Kool Smiles Smiles Changes Lives (520) 325-5665 South (520) 748-3501 East (888) 900-3554 www.smileschangeslives.org 70 Other 250% FPL; AHCCCS/KidsCare Low income and those with disabilities Dental for individuals referred by Native Americans for Community Action Tucson area; annual fee, discounted dental Braces for 11-18 years old; low income VIII. Native American Health Resources www.ihs.gov 71 VIII. Native American Health Resources a. General Information Native Americans have a choice of selecting either the American Indian Health Program (AIHP) or an AHCCCS Health Plan as their health care provider. Native Americans who choose the American Indian Health Program, may also receive services rendered by tribal providers and other AHCCCS-registered providers and health plans that will bill AHCCCS on a fee-for-service basis. If selecting an AHCCCS Health Plan, Native Americans can choose from several providers (within the network) across Arizona. You will be assigned a Primary Care Provider (PCP). This can be helpful if you don’t live near an AIHP facility or if you prefer to receive services from other providers. At any time, Native Americans may change enrollment from an AHCCCS Health Plan to the American Indian Health Program or from the American Indian Health Program to an AHCCCS Health Plan. Health plan to health plan changes may only be made at the member’s annual anniversary date. To select an AHCCCS health plan or the American Indian Health Program, contact the Division of Member Services at AHCCCS: Metro Phoenix: (602) 417-7100 Outside Phoenix: (800) 334-5283 Fax: (602) 252-2136 b. American Indian Health Program (formerly “Indian Health Service”) Indian Health Service facilities still exist. However, when a Native American wants to receive services through AHCCCS, they are enrolled in the “American Indian Health Program.” For more information on AIHP call your local area office: · Phoenix Area American Indian Health Program – (602) 364-5039 · Tucson Area American Indian Health Program – (520) 295-2405 · Navajo Area American Indian Health Program – (928) 871-5811 Each area office has service units, hospitals and clinics throughout Arizona. c. Questions and Answers For more information you may also contact AHCCCS Native American Coordinator at (602) 417-4610 or visit the website www.azahcccs.gov/tribal/default.aspx. 72 IX. Services for Children with Special Needs www.hs.state.az.us/phs/ocshcn 73 IX. Services For Children With Special Needs a. What are Special Needs? This section describes services for children with a wide variety of “special needs” from those with physical and mental disabilities to those with learning disorders, chronic illnesses, or any kind of condition that is potentially disabling. It also describes services for kids in foster care and those with birth defects, epilepsy, burn scars, metabolic disorders, sickle cell anemia, children who are developmentally delayed and many more. Different programs define their special needs populations differently, so call to find out if your child qualifies for a specific program. b. Arizona Department of Education (ADE) Services Exceptional Student Services The Arizona Department of Education works to identify children with delays or disabilities even before they start school. Even parents of young children (birth – 5 years) can contact their local school, school district or Child Find to have their child evaluated and screened. Contact Information (602) 542-4013 (800) 352-4558 AZ Find · Works to identify all children from birth through age 21 with delays or disabilities. · When children are “found” they are referred to a specialist to screen their development. · If eligible, the Arizona Early Intervention Program (AzEIP) or a public school system will offer early intervention or special education services according to the child’s needs. · (928) 679-8106or (800) 352-4558 Parent Information Network · The Parent Information Network provides parents with information so they can actively participate in their child’s special education. · For more information, call and ask for the Parent Information Network at (602) 542-4013 or (877) 230-7467 Early Childhood Special Education · Works to ensure quality education services for children with disabilities, ages 3-5 years. 74 · If you suspect a child may have a developmental delay or difficulty learning that may affect them educationally, contact your local school district for an evaluation to determine eligibility for early childhood special education preschool services. Transition Services · · · Assists students in visualizing life beyond high school and developing a long-range plan. Ensures the attainment of skills and competencies necessary to achieve the vision. Identifies and connects students with the appropriate agencies, programs and services prior to school exit which the student will need to achieve his/her post-school vision. (877) 230-7467 c. Children's Rehabilitative Services Children’s Rehabilitative Services (CRS) Arizona’s Children’s Rehabilitative Services (CRS) is a program that provides medical treatment, rehabilitation, and related support services to AHCCCS enrolled members who have completed the CRS application and meet the eligibility criteria to be enrolled in CRS. UnitedHealthcare Community Plan CRS is the AHCCCS health plan that manages the integrated CRS program to provide primary, specialty and behavioral health care services for individuals from birth to age 21 with a one-time option for members to remain beyond age 21. http://www.uhccommunityplan.com/az/medicaid/childrens-rehabilitative-services.html CRS Services CRS services are delivered via a statewide network of Primary Care Providers, specialty and behavioral health providers. Upon enrollment CRS members are assigned to one of four geographically based Multi-Specialty Interdisciplinary Clinics located in Flagstaff, Phoenix, Tucson and Yuma. CRS Eligibility Requirements · Individuals under 21 years of age who are enrolled in AHCCCS · U.S. citizens or qualified aliens · Arizona Resident · Diagnosed with a CRS covered condition Medical Eligibility Conditions accepted for care include, but are not limited to: · Cerebral palsy · Club feet · Cleft Lip/Cleft Palate · Scoliosis 75 · · · · · · · Spina Bifida Heart Conditions due to congenital anomalies Metabolic disorders Muscle and nerve disorders Sickle cell anemia Neurofibromatosis Cystic Fibrosis CRS Application: · Anyone can complete a CRS application · The CRS application is available online at: www.azahcccs.gov · Once completed, the CRS application can be faxed or mailed to AHCCCS. o Fax: 602-252-5286 o Mail to: AHCCCS-CRS Attn: CRS Enrollment 801 E Jefferson MD 3500 Phoenix, AZ 85034 If you have any questions contact CRS Member Services. Member Services is available Monday through Friday from 8 a.m. to 5 p.m., excluding state holidays, by calling 1-800-348-4058 or 1-800-367-8939 (TDD) or 711 for the hearing impaired. d. Arizona Early Intervention Program, Division of Developmental Disabilities, and Arizona Long Term Care System The Arizona Early Intervention Program (AzEIP) and the Division of Developmental Disabilities (DDD) are run by the Department of Economic Security (DES). The Arizona Long Term Care System (ALTCS) is run by AHCCCS. Contact Information: (602) 532-9960 or (888) 439-5609 AzEIP AzEIP is for children between birth and 36 months of age who are “developmentally delayed” or who have an established condition that has a high probability of resulting in a developmental delay. A child from birth to 36 months of age will be considered to exhibit developmental delay when that child has not reached 50 percent of the developmental milestones expected at his/her chronological age, in one or more of the following domains: · physical/fine and/or gross motor/sensory · cognitive/adaptive · language/communication · social/emotional · self-help/adaptive Determination that a child is developmentally delayed will be based on professional evaluation or assessment and will include parental involvement and input. Established conditions that are deemed to result in a high probability of developmental delay include, but are not limited to: 76 · · · · · · · · · · · chromosomal abnormalities metabolic disorders hydrocephalus neural tube defects (e.g., spina bifida) intraventricular hemorrhage periventricular leukomalacia cerebral palsy significant auditory impairment significant visual impairment failure to thrive severe attachment disorders Children found eligible for AzEIP may receive the following services: · An assessment of physical parameters · Developmental evaluation and/or discipline specific evaluation · Initiation of the identification of family resources, priorities and concerns · Parent education and support · Assistance with referrals for community-based services · A written developmental report · Multi-disciplinary case conferences as indicated · Transportation assistance to families having financial or transportation difficulties · Developmental evaluations completed in the home by clinic staff · Nutrition and social service evaluations · Provision of bi-lingual services when needed · Communication of the team findings regarding the child's developmental strengths, needs, medical issues, and eligibility to parents, primary care providers and any other team members the family identifies For more information, please contact DES at (602) 532-9960 or (888) 439-5609 or your local AzEIP program coordinator: Southern Apache County Hummingbird Early Intervention Services, LLC PO Box 107 Nutrioso, AZ 85932 Phone: (928) 339-4465 77 Coconino County, including the entire Hopi reservation and the Colorado Strip, but not including Colorado City or the Navajo Nation Northland-Rural Therapy Associates 125 E. Elm Ave, Suite 103 Flagstaff, AZ 86001 Phone: (928) 779-1679 TF: (866) 779-1679 Graham, Greenlee, and Cochise Counties Easter Seals Blake Foundation 1115 E. Florence Blvd, Suite C Casa Grande, AZ 85222 Phone: (520) 723-4429 TF: (800) 851-6266 Gila County, including the entire San Carlos Reservation, but not including the White Mountain Reservation Easter Seals Blake Foundation 1115 E. Florence Blvd, Suite C Casa Grande, AZ 85222 Phone: (520) 723-4429 TF: (800) 851-6266 La Paz and Mohave Counties, not including the Colorado Strip Milemarkers Therapy, Inc. 276 S. Lake Havasu Ave. #A-11 Lake Havasu City, AZ 86403 Phone: (928) 854-5439 Maricopa County, 1a: East, will include the following zip codes: Maricopa County, 1d: Southwest, will include the following zip codes: 85201, 85203, 85204, 85205, 85206, 85213, 85215, 85234, 85256 85007, 85009, 85017, 85019, 85031, 85033, 85035, 85037, 85039, 85041, 85043, 85322, 85323, 85326, 85329, 85337, 85338, 85339, 85340, 85343, 85353, 85354, 85392, 85395, 85396 Maricopa County, 1b: Southeast, will include the following zip codes: 85207, 85208, 85209, 85212, 85236, 85242, 85249, 85295, 85296, 85297, 85298 Child and Family Resources 700 West Campbell, Suite 3 Phoenix, AZ 85013 Phone: (602) 234-3941, ext. 34 Maricopa County, 1c: South Central, will include the following zip codes: 85025, 85040, 85042, 85044, 85045, 85048, 85202, 85210, 85224, 85225, 85226, 85233, 85248, 85251, 85257, 85281, 85282, 85283, 85284, 85286 Rise, Inc. 4554 E. Inverness Ave Mesa, AZ 85206 Phone: (480) 497-1889 English: x 4925; Spanish x 4953 78 Maricopa County, 1e: Northwest, will include the following zip codes: Maricopa County, 1f: Central & Northeast, will include the following zip codes: 85303, 85305, 85307, 85309, 85311, 85312, 85318, 85320, 85335, 85342, 85345, 85351, 85355, 85358, 85361, 85363, 85373, 85374, 85375, 85376, 85379, 85380, 85381, 85382, 85383, 85385, 85387, 85388, 85390 85003, 85004, 85006, 85008, 85012, 85013, 85014, 85015, 85016, 85018, 85020, 85022, 85026, 85028, 85032, 85034, 85050, 85054, 85055, 85065, 85073, 85250, 85253, 85254, 85255, 85258, 85259, 85260, 85262, 85263, 85264, 85266, 85268, 85331, 85377 United Cerebral Palsy (UCP) 1802 W. Parkside Lane Phoenix, AZ 85027 Phone: (602) 682-1837 North Central, 1g: will include the following zip codes: 85021, 85023, 85024, 85027, 85029, 85051, 85053, 85083, 85085, 85086, 85087, 85295, 85301, 85302, 85304, 85306, 85308, 85310 United Cerebral Palsy (UCP) 1802 W. Parkside Lane Phoenix, AZ 85027 Phone: (602) 682-1838 United Cerebral Palsy (UCP) 1802 W. Parkside Lane Phoenix, AZ 85027 Phone: (602) 682-1838 Mohave and Coconino County, only including: Beaver Dam, Littlefield, Scenic, Uzona, and Desert Springs The Learning Center for Families 1192 W. Sunset Blvd. # 2 St. George, UT 84770 Phone: (928) 788-0029 Mohave and Coconino County, only including: Mohave and Coconino County, only including: Colorado City Centennial Park, Cane Beds, Moccasin and Fredonia The Learning Center for Families 1045 W. Utah Ave Hildale, UT 84784 Phone: (928) 788-0029 The Learning Center for Families 1192 W. Sunset Blvd. # 2 St. George, UT 84770 Phone: (928) 875-8711 Southern Navajo County Navajo Nation geographically located within AZ Northland Therapy Services PO Box 328 Show Low, AZ 85902 Phone: (928) 532-1532 Interagency Agreement with Navajo Nation Growing in Beauty Office of Special Education and Rehabilitation Services P.O. Box 1420 Window Rock, AZ 86515 Phone: (928)- 871-7682 TF: (866) 341-9918 79 Pima and Santa Cruz Counties Pinal County, including the entire Gila River Reservation, but not including Tohono O’Odham Reservation Easter Seals Blake Foundation 717 S. Alvernon Tucson, AZ 85711 Phone: (520) 792-2636 x 5218 Easter Seals Blake Foundation 1115 E. Florence Blvd, Suite C Casa Grande, AZ 85222 Phone: (520) 723-4429 TF: (866)543-7023 Yavapai County Yuma County High Country Early Intervention Program 3105 Clearwater Drive, Suite B Prescott, AZ 86305 Phone: (928) 776-9285 Child and Family Resources 201 S. 3rd. Avenue Yuma, AZ 85364 Phone: (928)- 783-4003 TF: (800) 929-8194 Beginning in March 2013, AzEIP is moving toward a team based early intervention model and will have new contracts as well as regions in place. Visit https://www.azdes.gov/main.aspx?menu=98&id=9634 to see updated information on the transition to this new delivery model. Division of Developmental Disabilities (DDD) DDD, which is within DES, provides support and services to eligible individuals with developmental disabilities. DDD coordinates support, services and resources through a central administrative office, six district offices and over 50 local offices in various communities throughout the state. DDD Eligibility An Arizona resident who has a chronic disability that was manifested before the age of 18 may be eligible. Individuals with the following diagnosis(es) may be eligible for DDD services: · Cognitive disability. · Cerebral palsy. · Epilepsy. · Autism. The disability must also result in “substantial functional limitations” in three or more of the following areas of major life activity: · Self-care: eating, hygiene, bathing, etc. · Receptive and expressive language: communicating with others. · Learning: acquiring and processing new information. · Mobility: moving from place to place. · Self-direction: managing personal finances, protecting self-interest or making independent decisions that may affect well being. · Capacity for independent living: ability to live on one’s own. · Economic self-sufficiency: being able to financially support oneself. 80 Children under the age of six years old may be eligible if there is a strongly demonstrated potential he/she has or will have a developmental disability. Any child from birth to 36 months who has a developmental delay, or who has an “established condition” which has a high probability of resulting in a developmental delay, may be eligible for support and services. Developmental delay occurs when a child has not reached 50% of the developmental milestones expected at his/her age in one or more of the following areas: · · · · · Physical. Cognitive. Language/communication. Social/emotional. Adaptive self-help. Established condition means a diagnosis of a physical or mental condition that has a high probability of resulting in a developmental delay. Application for services may be made at the Division office nearest you. You can find a listing of all of the local offices here. You may also submit a referral at www.azdes.gov/ddd and someone will contact you. You may call a local office and ask to speak with someone about an intake interview. Upon making an appointment, a Support Coordinator or Intake Worker will meet with you, review eligibility requirements and the documentation required, discuss your needs and possible support and help you complete the necessary paperwork. Documentation to establish eligibility includes items such as: · Proof of age (i.e., birth certificate). · Proof of residency. · Medical records. · Evaluations such as developmental, physical, occupational, speech and/or psychological. · School records or other records applicable to determination of eligibility and/or identification of needs. · Proof of any health insurance. Arizona Long Term Care System (ALTCS) ALTCS is a federally funded Medicaid program of support and services. Individuals who are eligible for services through the DDD may be eligible for services through ALTCS. If your Support Coordinator believes that you might be eligible for ATLCS, you will be referred to AHCCCS for eligibility determination. DDD provides both acute medical services and home and community based services to people who are eligible for ALTCS. People who are eligible for ALTCS will receive a Member Handbook which explains the program. ALTCS Services · Attendant Care · Day Treatment and Training · Employment Support Services · Habilitation 81 · · · · · · Home Health Aide Home Nursing Respiratory Therapy Respite Therapies: Occupational, Physical and Speech Transportation (Non-emergency) Central Administrative Office 1789 W. Jefferson St. Phoenix, AZ 85007 (602) 542-0419 (866) 229-5553 e. Other Department of Health Services Programs Family Voices A newsletter that provides valuable information to families who have children with special health care needs. · (505) 872-4774 or (888) 835-5669 · Raising Special Kids is the Family Voices State Affiliate organization in Arizona. (602) 242-4366 or (800) 237-3007 f. Social Security Benefits Children with a disability under age 18 who have limited income and resources or who come from homes with limited income and resources may be eligible to receive Supplemental Security Income (SSI) Benefits for Children. Or, they may be able to receive Social Security payments if one of their parents is deceased or receives Social Security Disability Insurance benefits. For more information: www.ssa.gov (800) 772-1213 or (800) 325-0778 (TTY) g. Children in Foster Care/Comprehensive Medical and Dental Program The Comprehensive Medical and Dental Program (CMDP) is the health plan responsible for ensuring, in partnership with foster care providers, the provision of appropriate and quality health care services for the well being of Arizona’s children in foster care. Children aging out of the foster care system may be eligible for the Young Adult Transitional Insurance program through AHCCCS. For more information contact Member Services at: (602) 351-2245 extension 11275 or (800) 201-1795 82 h. Other Resources Arizona State School for the Deaf and the Blind (ASDB) Educates children and youth with hearing or vision loss throughout Arizona. ASDB is committed to partnerships with families, school districts, communities, and others that will enable children and youth with hearing or vision loss to succeed now and in the future. · Tucson Campus (520) 770-3468 or (520) 770-3863 (V/TTY) · Phoenix Day School for the Deaf (602) 771-5300 · Desert Valleys Regional Cooperative (602) 544-1670 (V/TTY) · Early Childhood and Family Education (520) 770-3002 (V/TTY) · Eastern Highlands Regional Cooperative (928) 524-6770 (V/TTY) · North Central Regional Cooperative (928) 774-0655 · Southeast Regional Cooperative (520) 770-3200 (V/TTY) · Southwest Regional Cooperative (928) 317-0429 (V/TTY) Raising Special Kids Raising Special Kids provides support and information for parents of children with disabilities and special health care needs. Services by this non-profit are offered free of charge. (602) 242-4366 or (800) 237-3007 Leti Foundation The Leti Foundation addresses the unmet needs of multicultural families with children facing significant disabilities or complex educational and medical needs. (602) 978-9128 First Things First Undertakes activities to increase the quality of, and access to, the early childhood development and health system that ensures a child entering school comes healthy and ready to succeed. It seeks to improve the lives of children birth through age five, in order to ensure their readiness for school and support their families in preparing them for a lifetime of success and wellbeing. (602) 771-5100 or (877) 803-7234 Children's Developmental Center The Children’s Developmental Center, Arizona’s first comprehensive facility serving children, birth to five, with disabilities and behavioral challenges recently opened at Southwest Human Development. At the Children's Developmental Center families can expect: · Comprehensive evaluations, expert assessments, and individualized plans. · State-of-the-art therapy services to help each child develop to their full potential. · Care-coordination support for families to assure each child’s plan is understood and followed by everyone involved (e.g. teachers, child’s physician, therapists). · Knowledge and expertise about community resources. We act as advocates and a pointof-contact for resources that can help families. This includes working with other early intervention providers and educators to develop an appropriate and effective service plan · Services that take place in the home and in our center · Access to our full professional team 83 · Advice and assistance on payment issues Call (602) 468-3430 for additional information. 84 X. Small Business Employer Resources 85 X. Small Business/Employer Health Resources a. Small Business Health Options Program (SHOP) The Small Business Health Options Program (SHOP) is a new program that simplifies the process of buying health insurance for small businesses. It is part of the new Health Insurance Marketplace developed as a result of the Patient Protection and Affordable Care Act. The SHOP Marketplace is open to employers with 50 or fewer full-time-equivalent (FTE) employees. Full-time is considered 30 hours or more per week on average. Beginning in 2016, all SHOPS will be open to employers with up to 100 FTE’s. The advantages of using SHOP include: · You can control the coverage you offer and how much you pay toward employee premiums · You can compare health plans online on an apples-to-apples basis · The small business may qualify for a small business health care tax credit. This is only available for plans purchased through SHOP. As of June 2014, in order to apply for SHOP in Arizona, you will need to do so with the help of a Navigator, agent, broker or other assister, or download the application directly at https://www.healthcare.gov/how-do-i-apply-for-coverage-in-the-shop-marketplace/ You can reach a Navigator in your area but dialing 211. You can enroll in SHOP anytime throughout the year. The deadline to enroll is always the 15th of the month for coverage to be effective the 1st of the following month. For more information please call: Call 1-800-706-7893 (TTY users: 1-800-706-7915). Hours: Monday through Friday, 9 a.m. to 7 p.m. EST. Agents and brokers may also use this number. For more online information or to download an application, visit: https://www.healthcare.gov/small-businesses/ b. Arizona Small Business Association 4600 E Washington St, Suite 340 Phoenix, AZ 85034 (602) 306-4000 www.asba.com 4811 E. Grant Road, Suite 262 Tucson, AZ 85712 (520) 327-0222 ASBA Member Benefits Program 86 Participating in this program provides small business’ employees with access to medical, dental, vision and life insurance. For further information contact: Phone: (602) 386-5611 87 XI. Youth and Young Adults http://www.azahcccs.gov/ 88 XI. Youth And Young Adults a. Young Adult Transitional Insurance The Young Adult Transitional Insurance Program covers young adults from the age of 18 through their 26th birthday who were in DES Foster Care when they turned 18. Applicants must be US Citizens or Qualified Immigrants, Arizona residents and have a Social Security number. For more information call AHCCCS at (602) 417-7100 or (800) 334-5283. b. AHCCCS Care AHCCCS Care is a health plan that can be used for individuals or couples over the age of 18 who do not have children living with them. To qualify for AHCCCS C are: · Your income must not be above 100% of the Federal Poverty Level (FPL) · You must be a US Citizen or Qualified Immigrant and an Arizona resident · An enrollment freeze is scheduled to begin on this program beginning July 1, 2011, pending litigation. For more information and to apply call DES at (602) 542-9935 or (800) 352-8401. c. Continuing Education and Training Jobs Corps Jobs Corps is a national education and training program for unemployed and undereducated youths, ages 16-24. It is administered by the US Department of Labor. In addition to meeting the age requirements, applicants must be economically disadvantaged; a high-school dropout, or if graduated, in need of additional education, training or intensive counseling to obtain and hold meaningful employment; and a US citizen, legal resident, permanent resident alien or other lawfully admitted alien. Those eligible for Job Corps must also sign a commitment to remain free from violence and drugs. For more information contact · Phoenix Job Corps Center (Phoenix): (602) 254-5921 or (800) 733-5627 · Fred G Acosta Job Corps Center (Tucson): (520) 792-3015 or (800) 773-5627 89 Maricopa Community Colleges The Maricopa Community Colleges offer many academic and occupational courses in areas such as: · Art/Photography · Aviation and Aeronautics · Business and Computer Information Systems · Child and Family Studies · Communications and Fine Arts · Culinary Studies · Emergency Medical Technology · Nursing · Science and Math · Social and Behavioral Sciences · Language and Humanities · Wellness, Health, Nutrition and Physical Education · And many more … Call or visit your nearest community college to find out about specific programs and how to enroll: Chandler-Gilbert Community College www.cgc.maricopa.edu 2626 E. Pecos Road, Chandler (480) 732-7000 Estrella Mountain Community College www.estrellamountain.edu 3000 N. Dysart Road, Avondale (623) 935-8000 Mesa Community College www.mc.maricopa.edu 1833 W. Southern Avenue, Mesa (480) 461-7000 Phoenix College www.phoenixcollege.edu 1202 W. Thomas Road, Phoenix (602) 285-7800 Scottsdale Community College www.sc.maricopa.edu 9000 E. Chaparral Road, Scottsdale (480) 423-6000 GateWay Community College www.gatewaycc.edu 108 N. 40th Street, Phoenix (602) 286-8000 Glendale Community College www.gc.maricopa.edu 6000 W. Olive Avenue, Glendale (623) 845-3000 Paradise Valley Community College www.pvc.maricopa.edu 18401 N. 32nd Street, Phoenix (602) 787-6500 Rio Salado College www.riosalado.edu 2323 W. 14th Street, Tempe (480) 517-8000 South Mountain Community College www.southmountaincc.edu 7050 S. 24th Street, Phoenix (602) 243-8000 90 Other Community Colleges in Arizona: Arizona Western College www.azwestern.edu 2020 S. Avenue 8 E., Yuma (928) 317-6000 Cochise Community College www.cochise.edu 4190 West State Highway 80, Douglas (520) 515-0500 Dine College www.dinecollege.edu 1 Circle Drive Route 12, Tsaile (928) 724-6630 or (877) 988-3463 Mohave Community College www.mohave.edu 1971 Jagerson Avenue, Kingman (928) 757-4331or (928) 757-0875 Pima Community College www.pima.edu 4905 E. Broadway Boulevard, Tucson (520) 206-4500 Yavapai College 1100 E. Sheldon Street, Prescott www.yc.edu (928) 445-7300 Central Arizona College www.centralaz.edu 8470 N. Overfield Road, Coolidge (800) 237-9814 Coconino Community College www.coconino.edu 3000 N. 4th Street, Flagstaff (800) 350-7122 or (928) 526-7600 Eastern Arizona College www.eac.edu 615 N. Stadium Avenue, Thatcher (800) 678-3808 Northland Pioneer College www.npc.edu 103 N. 1st Avenue, Holbrook (800) 266-7845 Tohono O’odham Community College www.tocc.cc.az.us P.O. Box 3129, Sells (520) 383-8401 d. Other Services for Youth Florence Crittenton 715 W. Mariposa Street, Phoenix (602) 274-7318 This non-profit agency provides education and community-based programs to help children and teens overcome the issues of abuse, neglect, teen pregnancy and/or mental health problems. Services · Independent Living - Independent Living provides a positive pathway to adulthood for young people who have been in long-term foster care. The community-based program provides life skills training to teens and young adults, ages 16 to 21. Through one-to-one 91 · · case management and monthly workshops, Independent Living focuses on teaching participants how to support themselves and live without assistance. Residential Group Home - The residential facility is a safe haven for girls 12 to 18 who have been abandoned, neglected, or whose lives have become so difficult or unmanageable they are unable to cope any longer. Beyond providing basic needs, the Residential Group Home focuses on all aspects of the girls' health and well being. Successful Teen Parent Program - In addition to helping new young parents understand the responsibilities of having and caring for a child, the Successful Teen Program also helps these teens finish school, find work, manage money, obtain health care, arrange childcare, build support and improve family relations. HomeBase Youth Services Programs of Native American Connections This program is similar to the program above, targeting homeless and runaway Native American youth in the Phoenix area. Services provided include: · Street Outreach · Day Outreach Center · Transitional Living · Other links to affordable housing For further information call (602) 254-7777 or visit http://www.nativeconnections.org/behavioral-health/HomeBase-youth-services AZ Freedom to Work – Work Incentives Planning and Assistance This program offers benefits, planning and advisement for youth on Social Security disability benefits, so they can take advantage of work incentives and understand how earned income will impact their cash and medical benefits. For more information call (866) 304-WORK (9675) or visit: www.azfreedomtowork.org Arizona Youth & Family Services, Inc. Arizona Youth and Family Services (AYFS) is a community-based, child and family centered agency serving the greater Phoenix area. This program provides strength-based behavioral health services designed to assist children and adolescents with moderate-to-severe behavioral problems in maintaining their current living situation or moving to a more desirable placement. For more information call (602) 277-4833 or visit: www.azyfs.org/ Hospice of the Valley A pediatric program for children facing serious or life-limiting illness. - Provides services in hospital or at home. - Provides services for child and family For more information call (602) 776-1540, or visit the website: www.hov.org 92 XII. Other Community Health Resources 93 XII. Other Community Health Resources a. Arizona Department of Health Services and County Health Departments The Department of Health Services (DHS) is involved in a wide array of activities designed to promote and protect the health of Arizona’s citizens. County Health Departments offer a variety of low-cost medical services to the public. You DO NOT have to be on AHCCCS to be eligible for DHS Services. Your local County Health Department may offer services including: · · · · · · · · · · · · · · · · · · · · · Free or Low-Cost Immunization Services Tuberculosis (TB) Testing Tobacco Prevention Programs Breast and Cervical Cancer Screening Lead Poisoning Prevention Health Start (see more detailed information below) Newborn Intensive Care Programs Health Care for the Homeless Dental Health Programs Family Planning Services Prenatal Care Services Domestic Violence Programs Refugee Programs Leprosy Screening and Treatment Services for people with HIV/AIDS AIDS Drug Assistance Program HIV Counseling and Testing STD Testing and Education Women, Infants and Children (WIC) (see more detailed information below) Child Abuse and Neglect Prevention Programs Nutrition Programs For more information call DHS or your County Health Department. Arizona Department of Health Services 150 North 18th Avenue Phoenix, Arizona 85007 Main Phone: (602) 542-1001 Referral and Information Line: (800) 314-9243 Web: www.azdhs.gov 94 The Referral and Information Line receives calls from across Arizona and provides information about: · · · · Immunization Locations Traumatic Brain Injury Referrals Early Intervention Referrals Links and Contact Numbers to other DHS Programs and Services Apache County Health Department Chris Sexton, Director (928) 337-7525 csexton@co.apache.az.us Coconino County Health Department Barbara Worgess, Chief Health Officer (877) 679-7272 (Flagstaff Area) (888) 645-2283 (Page Area) (928) 679-7272 bworgess@coconino.az.gov Graham County Health Department Neil Karnes, Director (928) 428-1962 nkarnes@graham.az.gov La Paz County Health Department Marion Shontz, Exec. Director (928) 669-1100 mshontz@co.la-paz.az.us Mohave County Health Department Patty Mead, Director (928) 753-9141 Patty.Mead@co.mohave.az.us Phoenix Area Indian Health Service Dorothy Dupree, Director (602) 364-5039 Dorothy.Dupree@ihs.gov Pima County Health Department Sherry Daniels, Director (520) 243-7770 Sherry.Daniels@pima.gov San Carlos Apache Tribe Department of Health and Human Services Velda A. Williams, Exec. Director (928) 475-2798 Velda.Williams@scat-nsn.gov Santa Cruz County Carlos Rivera, County Manager (No Dir.) (520) 375-7900 crivera@co.santa-cruz.az.us Yuma County Health Department Diana Gomez, Director (928) 317-4550 Diana.Gomez@yumacountyaz.gov Cochise County Health Department Mary Gomez, MN, Director (800) 423-7271 (520) 432-9400 health@cochise.az.gov Gila County Health Department Michael O’Driscoll, Director (928) 402-8811 (Globe Area) (928) 472-5367 (Payson Area) (800) 304-4452 (in state only) emsdept@co.gila.az.us Greenlee County Health Department Steven Rutherford, Director (928) 865-2601 srutherford@co.greenlee.az.us Maricopa County Health Department (602) 506-6900 Navajo County Health Department Wade Kartchner, Director (928) 524-4750 w.kartchner@navajocounty.az.gov Tucson Area Indian Health Services George Bearpaw, Acting Director (520) 295-2405 George.Bearpaw@ihs.gov Pinal County Health Department Thomas Schryer, Director (866) 960-0633 Tom.Schryer@pinalcountyaz.gov Navajo Area Indian Health Service John Hubbard, Jr., Director (928) 871-4811 John.Hubbard@navajo.ihs.gov Yavapai County Community Health Services Robert Resendes, Director (928) 771-3122 (Prescott Area) (928) 639-8132 (Verde Valley Area) Robert.Resendes@yavapai.az.us Gila River Indian Community Department of Public Health Laverne Dallas, Director (520) 550-8000 Laverne.Dallas@gric.nsn.us 95 Other DHS Programs Include: Health Start Health Start utilizes community members as lay health workers to improve birth outcomes and child health at a local level by increasing access to early prenatal care and monitoring a child’s immunization status and developmental milestones. Health Start clients receive education, support and advocacy services to address individual family concerns. The program serves: · Pregnant/postpartum women, who live in targeted communities and who have at least one risk factor known to impact birth outcomes. · Children, who receive periodic developmental screenings and referrals for intervention services as needed. · Families, who receive home visits and case management with oversight by nurses and social workers until the enrolled child reaches age two. Call (602) 364-1421 or visit http://www.azdhs.gov/phs/owch/healthstart.htm. Also see similar County Program(s) by calling (602) 304-1166 or viewing: http://www.maricopa.gov/PublicHealth/programs/HealthyStart/ Women, Infants, and Children (WIC) Arizona WIC is a federally funded program that provides Arizona residents with nourishing supplemental foods, nutrition education and referrals. Participants of WIC are either pregnant, breastfeeding, or postpartum women, and infants and children under age 5 who have nutritional needs and meet income guidelines. All services are free. WIC supplies women and children with healthy food at no cost – including milk, juice, cheese, eggs, cereal, peanut butter or beans and infant formula. New Breastfeeding promotion and support is now available and breastfeeding mothers are eligible to participate in WIC longer than non-breastfeeding mothers. Additional services include · Nutrition education sessions · Breast-feeding support and education · Nutritional one-on-one counseling · Referral services to other social service agencies and to maternal, prenatal and pediatric health services 96 Eligibility · You must be a pregnant, postpartum (up to 6 months after the birth of the infant), or breastfeeding woman (up to the infant’s first birthday); OR an infant; OR a child under 5 years of age. · Income cannot exceed 185% of the Federal Poverty Level (FPL). A new income eligibility chart will be implemented July 1, 2011. Visit WIC Income Eligibility Guidelines 2011-2012 for the new information. · Be at nutritional risk (an assessment will be completed at the time of enrollment). · Be a resident of Arizona. To enroll · Visit http://www.fns.usda.gov/wic/. · In Maricopa County, call (602) 506-6900. · Statewide, call (800) 252-5942. · At your appointment bring proof of income (such as a paycheck, tax return, or letter from employer for everyone who works). · If you have proof of AHCCCS, TANF, or Food Stamps you will meet WIC income eligibility. · Also bring proof of identity (such as a driver’s license, utility bill, or official identification). · At this appointment, you will undergo a simple health screening to determine nutritional risk. b. A to Z Child Health Links A to Z Child Health Links is an on-line clearinghouse of child health information for parents and health providers in Arizona. The website contains local resources, links to informative articles, physician resources, and more. http://www.azdhs.gov/phs/ocshcn/is/is_links.htm c. Prenatal Care South Phoenix Healthy Start - The purpose of Healthy Start is to help more babies be born healthy as a result of early and easy access to high quality, comprehensive prenatal care and the existence of a network of support for our community’s pregnant women. Services they provide: Case Management - Community Resources & Referrals Health Education & Information - Participant Advocacy Depression Screening - Access to healthcare Group Education Classes & other group activities 97 For more information contact South Phoenix Healthy Start at (602) 304-1166. Address 2737 W. Southern Ave. Suite 8, Tempe, AZ 85282. d. Birth to Five Helpline This toll-free “warm line” covers a full range of concerns families may have about their children. The Birth to Five Helpline provides vast resources that answer critical questions about topics such as health, child development, nutrition, sleep, safety, and school readiness. The Helpline is staffed by a group of professionals including early childhood developmental specialists, registered nurses, disabilities specialists, early literacy specialists, and mental health counselors. · Hours of operation are Monday – Friday, 8 am – 8 pm and Saturday, 10 am – 2 pm. (877) 705-KIDS (5437) You may also send an email question at http://www.swhd.org/get-help/birth-to-fivehelpline. e. Centers for Independent Living (Arizona Statewide Independent Living Council) The Centers for Independent Living serve individuals of all ages with all types of disabilities. They are private, non-profit, non-governmental organizations. The majority of staff and Board of Directors of Centers for Independent Living are people with disabilities. For a complete listing visit Arizona Statewide Independent Living Council at http://www.azsilc.org/. Centers for Independent Living ABIL (Arizona Bridge to Independent Living) (602) 256-ABIL (2245) azbridge@abil.org www.abil.org (800) 280-2245 Voice/TTY DIRECT (520) 624-6452 direct@directilc.org Tucson/Southern Arizona (800) 342-1853 Voice/TTY www.directilc.org New Horizons ILC Prescott Valley and Northern Arizona dhenderson@newhorizonsilc.org Prescott Valley www.Newhorizonsilc.org (928) 772-1266 (800) 406-2377 Voice/TTY 98 Centers for Independent Living S.M.I.L.E. (928) 329-6681 (Services Maximizing Independent Living and Empowerment) (866) 239-SMIL (7645) Yuma area https://volunteer.truist.com/snap211/org/1482438.html (928) 782-7458 Voice/TTY ASSIST! to Independence (928) 283-6261 Tuba City (928) 283-6267 Voice/TTY http://www.assisttoindependence.org (888) 848-1449 CyberCil http://www.cybercil.com Web based f. Child Care Resource and Referral The Arizona Child Care Resource and Referral (CCR&R) is a free community service that matches parents seeking child care with child care resources. CCR&R also provides training and technical assistance to child care providers. CCR&R can assist: · · · · Parents seeking child care resources Child care providers seeking help with their work Employers trying to assist parents Community organizations involved with children For more information call CCR&R at (800) 308-9000 or visit http://arizonachildcare.org/. g. Child Protective Services To Report Child Abuse or Neglect Call: (888) 767-2445 In an immediate emergency call 911 Parents who abuse or neglect children need help, but many are afraid to seek it. You can help by: · Reporting suspected child abuse or neglect by calling (888) SOS-CHILD (888) 767-2445 · Helping a relative, friend or neighbor cope with the problems that may lead to child abuse or neglect. · Guiding a relative, friend, or neighbor to local family resources. 99 · · · · · Volunteering your time with your local child abuse prevention programs. Making an annual state tax check-off to support child abuse prevention. Donating to community agencies that provide support services to children and families. Becoming a licensed foster caregiver - call (602) 255-KIDS for information. Providing permanency for a child through adoption. If you know of a family that may have a non-emergency need for assistance, contact the DES Administration for Children, Youth and Families at (602) 542-3981. h. Maternal, Infant and Early Childhood Home Visiting Programs In 2010, President Obama signed into law the Patient Protection and Affordable Care Act. This act establishes the Maternal, Infant and Early Childhood Home Visiting Program (MIECHV) that provides funds for evidence-based home visiting to families in “at-risk” communities. These grants go towards Home Visiting Programming aimed at supporting families for free in a variety of ways from teaching parents how-to be their child’s first ‘teachers’; to providing guidance and information in regards to developmental milestones; to early childhood literacy and optimal physical and emotional health for their young children and more. Programs include: Nurse-Family Partnership Arizona Health Start Early Head Start Family Spirit Healthy Families Arizona High Risk Perinatal/Newborn Intensive Care Program HIPPY – Home Instruction for Parents of Preschool Youngsters Parents As Teachers SafeCare To fnd out more about whether there is a program in your area please visit: http://strongfamiliesaz.com/what-is-available-in-your-area/ You can also go to http://strongfamiliesaz.com/programs/ to review programs and contact the programs directly. 100 i. Comunity Information and Referral Community Information and Referral (CIR) is a private, non-profit organization. They are a vital link between people who need help and the organizations which provide that help. The CIR phone number is available 24 hours a day, seven days a week to provide free services to the residents of Arizona. CIR has trained bilingual (English/Spanish) Information and Referral Specialists available 24 hours a day, every day of the year. The service is anonymous and free to the public. 24 Hour Information and Referral Helpline: · 2-1-1 within Arizona · (877)211-8661 from anywhere · Using TDD: (800) 367-8939 or 711 You can also find information and referrals on CIR’s website at http://www.cirs.org. j. Domestic Violence For information on resources in your community call: · The Arizona Coalition against Domestic Violence at (602) 279-2900 or (800) 782-6400 8:30 am to 5:00pm M-F · National Domestic Violence Hotline at (800) 799-7233 24 hour hotline · Rural Safe Home Network Program at (602) 542-7341 · Arizona Humane Society Project Safe House (provides temporary foster care for pets of domestic violence victims) at (602) 997-7585 · Adult Protective Services: To report abuse, neglect, and exploitation of Arizona’s vulnerable or incapacitated adults, 24 hours a day, 7 days a week call (877) SOS-ADULT or (877) 767-2385 If you are in immediate danger DIAL 911. k. Family Planning Several sources of family planning are available in Arizona, including AHCCCS (see related section above under AHCCCS Services), the Arizona Family Health Partnership, and the Arizona Department of Health Services, and Planned Parenthood. Arizona Family Health Partnership Through a network of community-based subcontractors, Arizona Family Health Partnership offers free or low-cost family planning services based on family income. At most of the clinics 101 listed below individuals with an income up to 100% of the Federal Poverty Level (FPL) are eligible for free services and individuals up to 250% of FPL are served on a sliding-fee scale based on income level. All services are confidential. Teens seeking services may receive confidential services without parental involvement and cost of services is based on their individual income. A wide range of family planning services is available including: · Physical Exams · Birth Control · Counseling and Education · Pregnancy Testing · Infertility Screening · Sterilization · Testing and Treatment of Sexually Transmitted Diseases (STDs) · HIV Testing and Counseling · Emergency Contraception For More Information you can call Arizona Family Health Partnership at (602) 258-5777 (from Maricopa County) or (888) 272-5652 (from outside Maricopa County). You can also view the Directory of Family Planning Services for Arizona at: https://www.arizonafamilyhealth.org/locations-2/#.U6DV3PldXTo The AZ Department of Health Services, Bureau of Women’s and Children’s Health Family Planning Program The ADHS Family Planning Program is a statewide, clinic based program that provides comprehensive reproductive health services to promote optimal health in Arizona’s women. Women at or below 150% of the Federal Poverty Level (FPL) can receive services free of charge. Women who are above 150% of the FPL will be provided services on a sliding fee scale. All services are confidential. The following services are included as part of an annual exam: · History · Education · Counseling · Physical Assessment · Pregnancy Testing · Sexually Transmitted Disease Screening and Assessment · Referral and Follow up For more information visit: http://www.azdhs.gov/phs/owch/women/familyplanning.htm 102 ADHS Provider by County Apache County Health Department PO Box 697 St John AZ 85936 Cochise County Health Department 1415 West Melody Lane Bldg A Bisbee, AZ 85603 Coconino County Department of Health Services 2625 North King Street Flagstaff, AZ 86004 Gila County Health Department 5515 South Apache Avenue Suite 100 Globe, AZ 85501 Graham County Health Department 826 West Main Safford, AZ 85546 Greenlee County Health Department 253 5th Street Clifton, AZ 85533 La Paz County Health Department 1112 Joshua Street #206 Parker, AZ 85344 Maricopa Integrated Health Systems 2601 East Roosevelt Street Phoenix, AZ 85007 Mohave County Health Department 700 West Beale Street Kingman, AZ 86402 Navajo County Public Health Services District 117 East Buffalo Holbrook, AZ 86025 Yavapai County Community Health Services 1090 Commerce Drive Prescott, AZ 86305 Yuma County Department of Public Health 2200 West 28th Street # 137 Yuma, AZ 85364 Phone Number (928) 337-7592 (520) 432-9400 (928) 679-7272 (928) 425-3189 ext. 8811 (928) 428-0110 (928) 865-2601 (928) 669-6155 (602) 344-5011 (928) 753-0743 (928) 524-4750 (928) 583-1000 (928) 317-4540 Planned Parenthood For medical questions or to schedule an appointment with your nearest Planned Parenthood Center, call toll-free (800) 230-PLAN (7526). Planned Parenthood Arizona · (602) 277-7526 – Phoenix 103 · · (520) 624-1761 – Tucson www.ppaz.org l. Nutrition Assistance (formerly the Food Stamp Program) and Food Banks The Nutrition Assistance program provides eligible households with nutrition assistance benefits to help supplement their nutritional diets. Nutrition Assistance benefits may be used to purchase eligible food products and various other products as approved by the program. The Nutrition Assistance Program is administered by the Family Assistance Administration (FAA), which is part of the Arizona Department of Economic Security (DES). To apply for the Nutrition Assistance Program · Call Family Assistance Administration at (800) 352-8401 or (602) 542-9935 · Call your local DES Office – they will direct you to your local FAA Office where you can apply (or see the list of FAA Offices under the DES section of this binder) · Apply online at www.healthearizonaplus.gov. Eligibility · To be eligible for the Nutrition Assistance Program you must meet certain low-income guidelines depending on your family size and composition. · Your local Family Assistance Administration office can tell you if you are eligible for the program. Food Banks · Yavapai Food Bank, Inc. (928) 775-5255 · Westside Food Bank, Surprise/Phoenix (602) 242-3663 · Desert Mission Food Bank, Phoenix (623) 434-6255 · St. Mary’s Food Bank, Phoenix (602) 352-3640 · St. Vincent de Paul, Statewide (602) 495-3051 · United Food Bank, Mesa (480) 926-4897 · Community Food Bank, Tucson (520) 884-1098 · Yuma Community Food Bank, Yuma (928) 343-1243 · Wilson-Batiz Borderland Food Bank, Nogales (520) 287-2627 104 m. Head Start · Head Start is a federally funded child and family development program for low-income families and families whose children have disabilities or other special needs. Head Start serves children from 3-5-years-old, with priority given to 4-year-olds who will enter kindergarten the following year. Assistance is provided through five service components: education, health, nutrition, social services, and parental involvement. Through these five service components, children may receive individualized learning experiences, physical examinations, immunizations, hot meals and more. · Early Head Start has programs geared for children 0-3 years of age. · Migrant Head Start has programs designed for children, 0-5 years, of migrant and seasonal worker families. · American Indian Alaskan Native Head Start addresses the specific needs of children, 0-5 years of age, from these populations. Eligibility For Head Start, children must be 3-4 years of age before September 1 of each school year. Families must meet certain low-income requirements. (Note: Families of children with special needs may not be subject to income eligibility requirements.) How to Apply Contact your regional Head Start Office to find out their specific requirements for eligibility and enrollment. Each program is slightly different. Apache, Coconino, Navajo, and Yavapai Counties NACOG Head Start: (928) 774-9504 La Paz, Mohave, and Yuma Counties · Yuma County (928) 782-1886 · La Paz County (928) 669-9466 · Mohave County (928) 753-6247 Pinal and Gila Counties Pinal /Gila Community Child Services: (520) 7235321 Cochise, Graham, Greenlee, Pima, and Santa Cruz Counties Child Parent Centers, Inc.: (520) 882- 0100 105 Maricopa County · Maricopa County Head Start: (602) 506-5916 · East Side: (480) 464-9669 Ext: 200 · West Side: (623) 486-9868 · Central, Northeast, and East Phoenix: Southwest Human Development, (602) 2665976 · Central, South, and West Phoenix: (602) 262-4040 n. Homeless Services Maricopa County · André House o “André House, located in downtown Phoenix, is a house of hospitality that reaches out to those most in need by offering simple services like food, clothing, showers, blankets and shelter.” o 213 S 11th Av, Phoenix AZ 85007 o (602) 255-0580 o www.andrehouse.org · Area Agency on Aging – Care Directions o “Care Directions® has served over 9,000 HIV positive people living throughout Maricopa and Pinal Counties. In addition to serving the general population, specialized case management is provided to women, children, youth, teens and the homeless. Services are available in English and Spanish.” o 1366 East Thomas Road Suite 200 Phoenix, Arizona 85014 o (602) 264-CARE (2273) o caredirections.org · Central Arizona Shelter Services, Inc. (CASS) o 230 S. 12th Avenue o (602) 256-6945 o Operates three primary shelters: Downtown Single Adult, Men’s Outreach Shelter and Vista Colina Emergency Family Shelter o http://www.cassaz.org/ · Community Bridges - The Center for Hope for Women, Infants & Children o “CFH Offers long-term support and residential services to pregnant women in need of a safe and structured environment to address their physical, mental, and emotional health needs. CFH offers group and individual counseling, parenting programs, relapse prevention, job skills training, housing, family counseling, and an on-site child development center for toddlers and infants.” o (480) 461-1711 o http://communitybridgesaz.org/women-and-children-programs/ · Chicanos Por La Causa, Inc. – De Colores Domestic Violence Shelter o “De Colores Domestic Violence Shelter opened its doors in 1985 to serve as a safe haven for women and their children who have been forced to flee their home due to domestic violence. De Colores has developed a special focus on monolingual Spanish speaking women and their children. As a result, it has become the only domestic violence shelter in Maricopa County in which all staff and services are bicultural and bilingual. The facility includes 58 beds, a laundry facility, indoor and outdoor play areas, a learning center, a communal kitchen and dining area. Staff is available 24 hours a day.” 106 o (602) 269-1515 · Child Crisis Center o “Children are placed in our shelter either through Child Protective Services or by their families as a Community Placement. They may stay from several days to many months, depending upon their circumstances.” o If you know children that need a safe place to stay temporarily, please call or visit the Child Crisis Center at ANY hour. o 604 W 9th St Mesa, AZ 85201 o (480) 969-2308 o www.childcrisis.org · Chrysalis – Crisis Shelter and Transitional Housing o “Chrysalis operates a residential crisis shelter. The shelter can house up to 50 adults and children at once. During their stay (up to 120 days) residents can receive individual and group counseling and case management. Assistance with job development, housing and financial referrals, medical services, parenting information, etc. is provided based on the needs of the individual. Counseling can be provided to children living in shelter.” o (602) 944-4999 o http://www.noabuse.org/ · CONTACS (Community NeTwork for Accessing Shelter) Shelter Hotline o (602) 263-8900 OR (800) 799-7739 o Call 24-hours-a-day, 7-days-a-week o Bilingual o Provides help in locating emergency, homeless or domestic violence shelters o http://www.cir.org/contacs/ · Crisis Nursery – Children’s Shelter o “Children's Shelter provides a safe haven for children threatened with abuse and neglect and a life line for parents facing emergencies that pose risks to their children well-being. Shelter staff is available 24/7 to respond to inquiries and accept admissions. Both overnight stays and day respite services are available for children from birth to 8 years of age on an emergency or planned basis. Length of stay is based on the individual needs of each child and family.” o 2334 East Polk Street Phoenix, AZ 85006 o (602) 273-7363 o www.crisisnurseryphx.org · Ebony House, Inc. o "Ebony House, Inc. is a non-profit agency providing standard and intensive behavioral health out-patient treatment services; outreach, education and prevention services to adults, children and their families; and Level II Residential Treatment for adult men; and Level II Residential Treatment for women, targeting pregnant and parenting women in the community who are suffering 107 from issues related to substance abuse and co-occurring disorders. Ebony House also provides HIV/AIDS/STD counseling and testing, along with Health Education and Risk Reduction (HE/RR) health fairs, outreach services, and provides mobile units that travel across Maricopa County giving HIV oral swab tests to anyone that wishes.” o 6222 S. 13th Street Phoenix, AZ 85042 o (602) 276-4288 o www.ebonyhouseinc.org · Homeward Bound o “At Homeward Bound, we assist homeless and domestic violence families with children achieve economic independence, secure long-term, safe, decent, affordable housing and break multi-generational cycles of homelessness and domestic violence.” o Phoenix o (602) 374-8717 o www.hbphx.org · House of Refuge East o “House of Refuge is a faith-based non-profit organization helping homeless families and individuals in crisis by providing transitional housing and supportive services that assist participants as they strive towards self-sufficiency and seek to obtain permanent housing.” o 6935 E Williams Field Rd., Mesa, AZ 85212 o (480) 988-9242 o http://houseofrefuge.org/ · Human Service Campus o 220 South 12th Avenue, Phoenix, AZ 85007-3101 o (602) 229-1241 · Central Arizona Shelter Services, Inc. (CASS) - Provides nightly emergency shelter and supportive services to more than 400 homeless men and women, including 400 single-bunked emergency shelter beds for individual men and women, shower and laundry facilities, an employment program and a state-of-the art and a dental clinic offering comprehensive care. · Maricopa County Healthcare for the Homeless (HCH) – Provides integrated primary healthcare, mental health services, substance abuse services and case management for homeless men, women and children. HCH delivers health care through an interdisciplinary approach, combining aggressive street outreach, primary healthcare, mental health service and substance abuse counseling. · Northwest Organization for Voluntary Alternatives (NOVA) Safe Haven – Provides severely mentally ill homeless individuals with residential services, case management and assistance with independent living skills. One of two 108 HUD-designated safe havens in Arizona, NOVA Safe Haven (NSH) services hard-to-reach homeless people with severe mental illness. Twenty-five emergency shelter beds and a daytime drop-in center, offering supportive and psychiatric services, form the core of the NSH program. http://www.novaarizona.org/safe.html · St. Joseph the Worker (SJW) – Housed in the Lodestar Day Resource Center (DRC), SJW assists homeless and low-income individuals to secure and maintain permanent employment. http://www.sjwjobs.org/ · St. Vincent de Paul (SVdP) – Co-located in the Lodestar Day Resource Center (DRC), SVdP provides daily meal service, ministry, counseling and referral service for homeless individuals living within downtown Phoenix. Mobilizing a large cadre of community volunteers, SVdP serves individuals and families who are homeless or at risk of becoming homeless. · Lodestar Day Resource Center (LDRC) – The Lodestar Day Resource Center serves as the hub of the campus and reflects both its collaborative nature and service integration focus. Winner of the National Association of Counties 2005 Platinum Innovation Award, the LDRC is the most innovative services enhancement within the HSC. In addition to providing the homeless with a safe place to be during the day, the LDRC offers a diverse range of holistic programs and workshops. The LDRC houses more than 10 member agencies, together with staff from HSC’s five anchor campus organizations and from a broad range of partner agencies from across the Valley. Working in close collaboration, these providers offer homeless outreach, benefit eligibility, behavioral health screening, housing assistance, legal assistance and a Homeless Court. They also join forces to provide employee development, training and placement. · LDRC Member Agencies: o Southwest Behavioral Health Services o People of Color Network o AZ Department of Economic Security o Veteran’s Administration o Madison Street Veterans Association o CASS Employment o LDRC Housing o Blueprints/ Community Bridges o St. Joseph The Worker o Chaplaincy for the Homeless o The New Arid Club 109 · Labor’s Community Service Agency o LCSA provides a transitional housing program that stabilizes and empowers homeless families by providing them with safe, transitional housing and comprehensive case management services. The overall objective is to help families attain self-sufficiency and move into permanent housing. o 3117 North 16th Street, Suite 100 Phoenix, Arizona 85016 o (602) 263-5741 o www.lcsaphx.org/home.html · Maggie’s Place o “Maggie's Place is a community of homes that provide hospitality for pregnant women who are alone or on the streets. We have a two-fold strategy in assisting mothers to grow. First, Maggie's Place provides for the immediate physical and emotional needs of our guests including shelter, food, clothing, and a supportive community. As such, we are a family and a community! In addition, Maggie's Place connects the mothers to the appropriate agencies and resources including prenatal care, health insurance, low-cost housing, and education programs.” o 4001 North 30th Street Phoenix, AZ 85016 o (602) 262-5555 o www.maggiesplace.org · Native American Connections o “Improving the lives of individuals and families through Native American culturally appropriate behavioral health, affordable housing, and community development services.” o 4520 N Central Avenue, Suite 600 Phoenix, Arizona 85012 o (602) 254-3247 o http://www.nativeconnections.org/ · A New Leaf o A New Leaf provides services ranging “from caring for the homeless at our family and men’s shelters, to providing safe haven for survivors of domestic violence and their children; from detention alternative programs for youth to foster care programs and behavioral health counseling for children.” o 868 E. University Dr. Mesa, AZ 85203 o (480) 969-4024 o www.turnanewleaf.org · Ozanam Manor o “Ozanam Manor provides transitional housing to homeless men and women age 50 and above; along with physically or mentally disabled adults age 18 and above.” o 1730 E. Monroe Phoenix, Arizona 85034 o (602) 850-6900 o http://www.stvincentdepaul.net/PS-OzanamManor.htm 110 · Phoenix Rescue Mission o Provides 3 meals daily to men, women and children o Men’s Emergency Shelter o Men’s Addiction Recovery Program o Changing Lives Center for Women and Children o 1801 S 35th Ave, Phoenix o (602) 233-3000 o http://phoenixrescuemission.org · Phoenix Shanti Group o “Provides emergency, transitional and supportive permanent shelter to individuals and families with HIV/AIDS. Persons accepted into the program will work with case management staff to develop and implement a plan for permanent housing and independence.” o 2345 W. Glendale Ave. Phoenix, Az. 85021 o (602) 279-0008 o www.shantiaz.org · Salvation Army o 2702 E. Washington Street, Phoenix o (602) 267-4196 o Emergency Assistance Program, Kaiser Family Homeless Shelter, Elim House Domestic Violence Shelter and Project HOPE (homeless outreach) o http://salvationarmycares.org · Save the Family o “Operates over 180 units of housing valley-wide. Provides transitional housing for homeless families and housing to keep working poor families stable through market adjusted rents.” o 450 W. 4th Place, Mesa, AZ 85201 o (480) 898-0228 o http://www.savethefamily.org/ · Sojourner Center o Emergency housing, food, clothing, and a continuum of support services for families & transitional housing for families leaving emergency shelter o P.O. Box 20156 Phoenix, AZ 85036 o (602) 244-0089 o www.sojournercenter.org · Society of St. Vincent de Paul o Dining, shelter services, food banks o 420 W Watkins, Phoenix o (602) 266-4673 o Other valley locations o http://www.stvincentdepaul.net/ 111 · Southwest Behavioral Health o “Southwest Behavioral Health provides subsidized independent housing, both permanent and transitional, to a variety of populations throughout Maricopa County including U S Veterans, persons that are homeless, persons with a serious mental illness and individuals with HIV/AIDS.” o “Southwest Behavioral Health also manages over 150 residential beds at locations throughout the valley. Programs range from supported independent living to intensely supervised (24-hour support). Length of stay varies depending on the individual's needs and ranges from 90 days to over 2 years.” o 3450 North 3rd Street Phoenix, Arizona 85012 o (602) 265-8338 o www.sbhservices.org · Standup For Kids o (800) 365-4KID (4543) o Provides housing referral, education assistance, vocational development, counseling, health services, transportation to self-help meetings, legal assistance, clothes, furniture, and other daily necessities o http://www.standupforkids.org/ · UMOM New Day Centers, Inc. o “UMOM New Day Centers mission is to provide homeless families and individuals with safe shelter, housing and supportive services to assist them in reaching their greatest potential.” o 3333 East Van Buren Street Phoenix, Arizona 85008 o (602) 275-7852 o http://www.umom.org/ Pima County · Casa de los Niños o 1101 N. 4th Avenue, Tucson o (520) 624-5600 o www.casadelosninos.org o Provides residential shelter care for children who are abused, neglected, or homeless · Church on the Street o 2551 W. Orange Grove Road, Tucson o Provides a hot meal in Santa Rita Park (22nd St. and 4th Ave.) every 2nd and 4th Sunday at 1:00 pm · Emerge Center o 2545 E Adams St, Tucson o (520) 795-9001 o www.emergecenter.org o Provides crisis intervention and housing 112 · The Giving Tree o 931 N Swan Rd, Tucson o (520) 320-5437 o Services include hot meals, emergency food boxes and clothing and toiletries for homeless, near-homeless and poverty-level children. · Gospel Rescue Mission o 312 W 28th St, Tucson o (520) 740-1501 o www.grmtucson.com o Offers emergency services of meals, shelter, clothing, showers, toiletries and case management services for men. · Old Pueblo Community Services o 4501 E Fifth Street, Tucson o (520) 546-0122 o http://www.helptucson.org/index.php o Provides transitional housing, veteran assistance, life skills training program. · Open Inn Shelter o 630 E 9th St, Tucson o (520) 628-9590 o Additional locations; referrals to: (520) 670-9040 or (866) 520-TEEN o openinn.org o Provides transitional and emergency shelter for unaccompanied youth. · Pio Decimo Center o 848 S 7th Ave, Tucson o (520) 622-2801 o Offers transitional shelter for families in South Tucson · Primavera o 200 E Benson Highway, Tucson o (520 623-4300 o http://www.primavera.org/index_flash.html o Shelter for men and families, clothing, food boxes, respite services, toiletries, showers, transportation services · TMM Family Services, Inc. o 1550 N Country Club Rd, Tucson o (520) 322-9557 o www.tmmfs.org o Provides transitional shelter for single women and women with children recovering from domestic violence, substance abuse and/or mental illness. o 113 · Tucson Salvation Army Hospitality House o 1021 N 11th Ave, Tucson o (520) 622-5411 o http://www.thesalvationarmytucson.org/HospHouse.html o Provides emergency shelter, meals, education and employment services · Tucson Planning Council for the Homeless o (520) 745-9443 o Provides services and referrals · Wingspan Anti-Violence Project o 430 E 7th Street, Tucson o (520) 624-1779 o 24 crisis line: (520) 624-0348 or (800) 553-9387 o www.wingspan.org o provides free, confidential 24-hour crisis intervention, information, support, emergency shelter and advocacy to LGBT victims/survivors of violence. · Winter Shelter Program o (520) 622-5411 or (520) 745-9443 o Provides overflow shelters, clothing bank during winter months Other Counties Apache County: Old Concho Community Assistance Center Concho (928) 337-5047 Motel Vouchers/Rent/Referral Services New Hope Ranch St. Johns (928) 337-5060 Coconino County: Alternatives Center for Family Based Services (Flagstaff) (928) 214-9050 Crisis Intervention/Information and Referral/Children and Families Cochise County: · Bisbee Coalition for Homeless (520) 432-7839 Emergency/Men · Hazel Fund – Wilcox Police Department (520) 384-4673 Families/Motel, Food, and Gas Vouchers · St. Vincent de Paul (Sierra Vista) (520) 458-0500 Motel Vouchers/Utilities/Rent/Medication Gila County: Veterans Helping Veterans (Payson) (928) 474-3920 Transitional/Men/Women/Veterans San Carlos Behavioral Health (928) 475-2371 or (928) 475-2798 Counseling/Shelter/Referral/Followup/Men/Women Catholic Social Services Aspen House Flagstaff (928) 226-8600 Transitional/Male/Youth Gila County Community Action Program Payson 114 Coconino Community Services Flagstaff (928) 522-7979 Motel and gas vouchers (928) 474-1759 Gila County Commity Action Program Globe (928) 425-3281 Hope Cottage Flagstaff (928) 774-9270 Transitional/Women and children Gila County Minsterial Association Globe (928) 425-2422 Northland Family Help Center Flagstaff (928) 774-4503 Emergency/children Salvation Army Globe (928) 425-4011 St. Vincent de Paul Globe (928) 425-3137 Sharon Manor Transitional Housing Complex Flagstaff (928) 773-1882 Time Out Shelter Payson (928) 472-8007 Salvation Army Flagstaff (928) 774-1403 Sunshine Rescue Mission Flagstaff (928)774-3512 Emergency/Men/Women Mohave County: Salvation Army Bullhead City (928) 758-3141 Motel and Gas Vouchers/Food Navajo County: Navajo County Emergency Services Holbrook (928) 524-4251 Shelter/Food/Referral Center Colorado River Region Youth Services Bullhead City (928) 763-1945 Lake Havasu City (928) 680-3678 Emergency/Youth Holbrook Senior Center Holbrook (928) 524-6044 Motel vouchers/rent and utility assistance/food/referrals Cornerstone Mission Kingman (928) 453-5800 Love Kitchen Charities Lakeside (928) 537-1252 Motel vouchers/rent and utility assistance/food/referrals 115 Mohave County Community Development Kingman (928) 753-0723 Northern Arizona Center-Homeless Winslow (928) 289-5798 St. Vincent de Paul Bullhead City (928) 758-5251 Lake Havasu City (928) 453-3125 Pinal County: St. Vincent de Paul Society Casa Grande (502) 836-2009 Food/Clothing/Lodging/Transportation Yavapai County: Catholic Social Services Cottonwood (928) 634-4254 Motel, food and gas vouchers Casa Grande Valley Outreach Center Casa Grande (520) 836-8196 Old Town Mission Cottonwood (928) 634-7869 Emergency Food/Gas Vouchers/Travelers Assistance/Medical Prescriptions Tri-Community Behavioral Health Oracle (520) 896-9240 referrals/counseling/women/children Verde Valley Guidance Clinic Cottonwood (928) 634-2236 Outpatient counseling/chemical dependency treatment/referrals/men/women/children Catholic Social Services Prescott (928) 778-2531 Transitional/Families/Motel First Baptist Church Reach-Out Program Prescott (928) 778-9790 Food/limited housing/utility assistance Just the Necessities Prescott (928) 771-0963 Project Aware Shelter Prescott (928) 778-7744 Emergency/transitional/Men 116 Salvation Army Prescott (928) 778-9150 Motel vouchers for families Turning Point Prescott (928) 778-7900 ER Hotline (800) 628-3089 Youth Crisis Yavapai County Veterans Administration Prescott (928) 445-4860 ext 6018 Adult Community Senior Center Sedona (928) 282-2834 Emergency/Families/Women/Meals Yuma County: Catholic Community Services in Western Arizona (928) 341-9400 Referral For general information about Homelessness in Arizona call the Arizona Coalition to End Homelessness at (602) 340-9393. o. Immunizations For general information about immunizations, contact TAPI, the Arizona partnership for immunization coalition at www.whyimmunize.org. Maricopa County The Maricopa County Childhood Immunization Partnership is a non-profit public/private partnership dedicated to increasing childhood immunization rates and childhood immunization awareness in Maricopa County. MCCHIP raises public awareness of free immunization clinics through their “free clinic brochure.” The brochure of times and locations for free immunizations is available at: 117 · · · www.mcchip.org. On the Maricopa County Department of Public Health’s website: www.wearepublichealth.org. By calling: o Maricopa County Public Health – (602) 506-6767 o Phoenix Fire Department Baby Shots – (602) 534-BABY (2229) o Chandler Regional Hospital (480) 728-3777 o http://www.cir.org/immunizations/ - for additional times of immunization clinics. To find out if your child’s shots are up to date, check with your child’s doctor, a school nurse, or speak with a community health nurse from the Maricopa County Department of Public Health at (602) 506-6767. Other Counties Check with your physician, your health plan, your community health center or your county health department. A list of County Health Department Contact information is available here: http://www.azdhs.gov/diro/liaison/countymap.htm p. Flu Clinics Flu Clinics · Flu clinics are established statewide during flu season. · Flu shot locations can be found by calling the 24 hour bilingual Flu/Pneumonia Hotline at (602) 324-2814 or (877) 764-2670. · www.cir.org · www.azdhs.gov/flu · Flu clinics can be found on the American Lung Associations Flu Clinic Locator at http://flucliniclocator.org or http://www.flushotsusa.com/ q. Legal Aid Community Legal Services · Provides civil legal services to indigent and low income residents · Eligibility Requirements: o Must meet federal poverty level guidelines o Legal issue must fall within priorities · Special units for migrant and seasonal farm workers · No/Low Cost · Contact: o 305 S. 2nd Avenue Phoenix, Arizona 85003-2402 o Telephone: (602) 258-3434 or (800) 852-9075 o Fax: (602) 254-3258 118 Arizona Foundation for Legal Services and Education (Charitable arm of the State Bar of Arizona) Phoenix – (602) 340-7366 www.azflse.org William E. Morris Institute for Justice Phoenix – (602) 252-3432 www.morrisinstituteforjustice.org/ Arizona Center for Disability Law Provides services statewide Phoenix- (602) 274-6287 or (800) 927-2260 Tucson- (520) 327-9547 or (800) 922-1447 www.azdisabilitylaw.org Another helpful website is: www.AZLawHelp.org Free/Discounted Legal Services Maricopa County: Pima County: Community Legal Services (Phoenix) – (602) 258-3434 or (800) 852-9075 Community Legal Services (Mesa) – (480) 833-1442 or (800) 896-3631 Advocates for the Disabled – (602) 212-2600 or (800) 875-2272 Arizona Center for Disability Law – (602) 274-6287 or (800)-927-2260 Arizona Senior Citizens Law Project – (602) 252-6710 Catholic Social Services (Immigration) – (602) 997-6105 Friendly House (Immigration) – (602) 257-1870 Navajo County: Southern Arizona Legal Aid – (520) 623-9461 or (800) 640-9465 Arizona Center for Law in the Public Interest: (520) 529-1798 Arizona Center for Disability Law – (520) 327-9547 or (800) 922-1447 Asylum Program of Southern Arizona – (520) 623-4555 Papago Legal Services – (520) 383-2420 White Mountain Legal Aid – (928) 537-8383 or (800) 658-7958 Chinle Agency Office – (928) 674-2064 Hopi Legal Services – (928) 738-2251 or (800) 789-9586 Fort Defiance Agency Office – (928) 729-4336 Tuba City Agency Office – (928) 283-5265 or (800) 789-8919 Southern Arizona Legal Aid – (520) 316-8076 or (800) 718-8086 Four Rivers Indian Legal Services (520) 562-3369 or (866) 312-2290 Pinal County: Yavapai County: Community Legal Services – (928) 445-9240 or (800) 233-5114 119 Catholic Charities – (928) 778-2531 Santa Cruz County: Apache County: White Mountain Legal Aid – (928) 537-8383 or (800) 658-7958 Southern Arizona Legal Aid, Inc (928) 338-4845 DNA-People’s Legal Service (928) 871-4151 or (800) 789-5824 Cochise, Greenlee, and Graham County: Southern Arizona Legal Aid – (520) 432-1639 or (800) 231-7106 Southern Arizona Legal Aid – (520) 287-9441 Coconino County: DNA-People's Legal Services, Inc.: (928) 774-0653 or (800) 789-5781 Flagstaff (928) 283-5265 or (800)789-8919 Tuba City Catholic Charities (928) 774-9125 Gila County: Southern Arizona Legal Aid – (928) 537-8383 or (800) 658-7958 Catholic Community Services in Southeastern Arizona Inc. (520) 432-2285 or (800) 338-2474 Mohave County: La Paz and Yuma County: Community Legal Services – (928) 681-1177 or (800) 255-9031 Community Legal Services – (928) 782-7511 or (800) 424-7962 Catholic Community Services in Western Arizona – (928) 341-9400 or (888) 514-3482 r. Gay, Lesbian, Bisexual, Transgender Resources Community Centers · 1n10 (602) 475-7456 www.1n10.org E-mail: coordinator@1n10.org 120 · · · 1 Voice Community Center 725 W. Indian School Road #125 Phoenix, AZ 85013 (602) 712-0111 www.1vcc.org Wingspan 425 E. Seventh Street, Tucson (520) 624-1779 www.wingspan.org E-mail: wingspan@wingspan.org Prescott Pride Center 111 Josephine Street, Prescott (928) 445-8800 www.prescottpridecenter.com E-mail: info@prescottpridecenter.org Other Resources · TG Harmony Scottsdale (602) 280-9074 www.binetaz.org Non-profit group offering resources, opportunities, and support for the entire transgender community in the Phoenix Area · Parents, Families and Friends of Lesbians and Gays (PFLAG) Tucson (520) 360-3795 www.pflagtucson.org Phoenix (602) 843-1404 www.pflagphoenix.org · Tucson GLBT Chamber of Commerce Provides a forum for Tucson’s GLBT business community (520) 615-6436 http://www.tucsonglbtchamber.org/ · Greater Phoenix Gay and Lesbian Chamber of Commerce (888) 4GP-GLCC (447-4522) or (602) 266-5055 www.gpglcc.org s. Medical Services Project The Medical Services Project (MSP) provides access to health-related services for uninsured, school age children and their siblings from low-income families in participating communities throughout Arizona. MSP is administered through the Arizona Chapter of the American Academy of Pediatrics. 121 Eligibility · · · · · Income requirements – the family’s household monthly gross income cannot be higher than 200% of the Federal Poverty Level. Child must not currently have health insurance coverage (can be in the application process) Child does not qualify for Arizona Health Care Cost Containment System (AHCCCS) or KidsCare Child does not qualify for Indian Health Service Child is currently a student (kindergarten - grade 12), a younger sibling of a school age child Services The MSP is a system of linkages between school nurses and volunteer health care providers who agree to accept a predetermined fee of $5 or $10 as payment-in-full for an office visit. Participating health care providers self-determine the number of children they are willing to see per month and the number may be changed at any time upon the providers’ request. MSP is designed to meet acute and episodic health care needs of the children participating and is neither an entitlement program nor insurance. MSP does not provide maintenance of chronic conditions. Medical providers are encouraged to utilize sample medications when available. If samples are not provided, the MSP provides able to pay for most medications up to a set annual amount. Lab services, when not available in the provider’s office, are provided through MSP as well. Children referred through the Medical Services Project can obtain medical, dental and other health-related services, including diagnostic procedures, prescribed medications, eyeglasses, and laboratory services. Contact Information For enrollment information, please contact your school nurse. For general information, please call the Project Manager at (602) 989-9353 or visit www.azaap.org/Medical_Services_Project. t. Medical Networks - Discounted Health Services These programs are designed to allow their members to receive some health services at discounted rates. THESE PRODUCTS ARE NOT INSURANCE COVERAGE but are a network of providers who are agreeing to see you for health services at a pre-negotiated discounted fee. 122 Pima Community Access Program (PCAP) Pima Community Access Program (PCAP) 2501 E. Elm Street Tucson, AZ 85716 (520) 694-0418 www.pcap.cc Services offered include doctor’s visits, hospitalization, laboratory services, radiology, specialty care, pharmacy discount plans and discounted transportation You are eligible for PCAP if: · You are not eligible for any other program (Medicaid, Medicare, employerbased, commercial or private) · You live in Pima County · Your income falls between 100% and 250% of the Federal Poverty Level PCAP offers affordable co-payments only if services are used, no monthly premiums, and a low membership fee. Eligible applicants will be screened for enrollment with Health-e-Arizona, a webbased electronic application process. Community Access Programs of Arizona- Mexico (CAPAZ-MEX) Community Access Programs of Arizona-Mexico (CAPAZ-MEX) – Yuma County (928) 627-1120 or (928) 627-9222 http://www.capazmex.com/ The Community Access Program of Arizona-Mexico CAPAZ-MEX is a Medical Safety Net to the uninsured and vulnerable residents of Yuma County. It is a program that facilitates access to professional healthcare at discounts prices the uninsured can afford. CAPAZ-MEX is a Discount Network, not a health insurance for Yuma County Residents in which the member is responsible for payment to healthcare provider at the time of the visit. Services offered include discounted doctor visits, hospitalization, laboratory services, primary and specialty services, and San Luis Walk-in-Clinic. You are eligible for CAPAZ if: · You are uninsured. 123 · Your income falls between 100% and 400% of the Federal Poverty Guidelines. Santa Cruz Health Connection Santa Cruz Health Connection 1852 N. Mastick Way Nogales, AZ 85621 (800) 311-0627 Services offered include doctor’s visits, hospitalization, laboratory services, radiology, specialty care, pharmacy discount plans, and discounted transportation. You are eligible for if: · You are not eligible for any other program (Medicaid, Medicare, employerbased, commercial or private) · You live in Santa Cruz County · Your income falls between 100% and 250% of the Federal Poverty Level Offers affordable co-payments, no monthly premiums, and a low membership fee. Eligible applicants will be screened for enrollment with Health-e-Arizona, a webbased electronic application process. u. Prescription Drug Discount Programs · PatientAssistance.com is a free resource designed to help connect patients who can’t afford their prescription medications with patient assistance programs. o Go to http://www.patientassistance.com/how-it-works.html, sign up for an account, locate prescription assistance programs and get medications. o Patient assistance programs can help patients receive assistance in acquiring their needed medicines at a discounted price. This site also posts medication coupons. For information on drug discount programs for seniors please see the Senior Section of this Manual. Yavapai County Discount Card The Yavapai County Discount Card is available to all Yavapai County residents. It can help if you are: · Without prescription drug insurance or waiting for it to start. · In need of medication not covered by your health insurance. · There is no cost to use this prescription drug discount program. · The cards are available at participating pharmacies, local libraries and community health center locations in Yavapai County. 124 · · · · · Card holders receive an average of 20% off retail and often save more on generic or mail order purchases. Nine out of 10 pharmacies nationwide accept this discount card. Family coverage with just one card, unlimited use. To learn more, call: (877) 321-2652. www.yavapaihealth.com/?page_id=1500 Prescription Assistance Service Free prescription medication is available for those who qualify. Qualifications: - The applicant cannot have prescriptions medication insurance that covers the needed medication. - The applicant does not qualify for government or other programs that provide prescription medications. - The applicant has an income level that causes a hardship when prescription medication is purchased. To see if you qualify and for additional information, call (928) 708-0727 v. School-Based Health Centers The Arizona School-Based Health Care Council is an alliance of organizations and individuals that provides basic, primary health services in 100 school sites throughout Arizona through School-Based Health Centers. School-Based Health Centers provide primary care services such as treatment for acute conditions like sore throats and earaches, chronic disease management like asthma and preventive services like immunizations, physical examinations, and health education. Some School-Based Health Centers also offer dental services, behavioral health services, and transportation. Most School-Based Health Centers are open one day per week while school is in session. Arizona School-Based Health Care Council 202 E McDowell Rd, #130m Phoenix, Arizona 85004 Phone: (602) 263-8002 Fax: (602) 258-5497 Web site: www.azsbhc.org Locations: www.azsbhc.org/locations.php w. Sexually Transmitted Diseases The clinics listed below can offer help with treatment and prevention of Sexually Transmitted Diseases (STDs): 125 Health Care Clinics Apache County Cochise County 130 S Mountain Ave, Springerville 126 W 5th Street, Benson (928) 333-2415 (520) 586-8200 4115 E Foothills Dr, Sierra Vista (520) 803-3900 1415 Melody Lane, Bldg A, Bisbee (520) 432-9400 450 S Haskell Ave, Willcox (520) 384-7100 Coconino County Department of Health Services 2625 N. King Street, Flagstaff (928) 679-6222 Greenlee County 253 5th Street, Clifton (928) 865-2601 PO Box 153, North of Fairgrounds, Duncan (928) 865-2601 LaPaz County 1112 Joshua Ave., Parker (928) 669-1100 Maricopa County County Health Department 1645 E. Roosevelt, Phoenix (602) 506-1678 Maricopa Medical Center 2601 E. Roosevelt, Phoenix (602) 344-5411 Phoenix Indian Medical Center 4212 N. 16th Street, Phoenix (602) 263-1200 Public Health Clinic 1825 E. Roosevelt St., Phoenix (602) 506-1678 Maricopa County (continued) Roosevelt Primary Care Center 1825 E. Roosevelt, Phoenix (602) 258-6381 Seventh Avenue Primary Care 1407 S. 9th Avenue, Phoenix (602) 344-6600 126 Sunnyslope Primary Care Center 934 W. Hatcher, Phoenix (602) 344-6300 Mohave County Navajo County 700 W Beale St, Kingman (928) 753-0714 117 E Buffalo St, Holbrook (928) 524-4750 1222 Hancock Rd, Bullhead (928) 758-0703 619 E Third St, Winslow (928) 289-6830 2001 College Dr, Lake Havasu City (928)453-0703 251 N Penrod Rd, #1, Show Low (928) 532-6050 Pima County Pinal County County Department of Health Theresa E. Lee Health Center 322 South Freeway, Tucson (520) 624-8272 575 N Idaho #301, Apache Junction (480) 982-0230 or (520) 866-6132 820 E Cottonwood Bldg E, Casa Grande (520) 836-5931 or (520) 866-7438 119 W Central, Coolidge (520) 723-4174 or (520) 866-7344 402 E First St, Eloy (520) 466-4136 or (520) 866-7454 355 Alden Rd., Kearney (520) 363-7612 or (520) 866-7873 110 Main St, Mammoth (520) 487-2110 or (520) 866-7850 500 S Central Ave, Florence (520) 866-7289 1470 Justice Dr, Oracle (520) 896-9777 (520) 866-7860 36711 W Papago Dr, Stanfield (520) 866-7995 60 E Main St, Superior (520) 689-5953 or (520) 866-6952 127 Santa Cruz County 1852 N Mastick Way, Nogales (520) 281-1550 Yavapai County Yuma County 1090 Commerce Dr, Prescott (928) 583-1000 County Health Department 2200 W. 28th Street # 178, Yuma (928) 317-4580 3212 N Windsong, Ste 200, Prescott Valley (928) 583-1000 10 S 6th Bldg C, Cottonwood (928) 639-8132 128 x. Social Security Administration The Social Security Administration is a Federal Agency that offers many services such as: · · · · · Social Security Retirement Benefits Survivor’s/Spouse’s Benefits Disability Benefits Medicare Health Insurance Benefits Supplemental Security Income (SSI) o Provides supplemental income for those who are age 65 and over, blind or who have a disability, including children, and who have little or no income and limited resources. Contact Information National toll-free number: (800) 772-1213 or www.socialsecurity.gov Arizona Offices: (800) 772-1213 Casa Grande – 501 N. Marshall Street Casa Grande, AZ 85222 Douglas – 600 E. 15th Street Douglas, AZ 85607 Flagstaff – 1585 S. Plaza Way, Ste. 130 Flagstaff, AZ 86001 Glendale – 5907 W. Kings Avenue Glendale, AZ 85306 Prescott – 205 N. Marina Street Prescott, AZ 86301 Safford – 650 S. 14th Avenue Safford, AZ 85546 Tucson – 3500 N. Campbell Avenue Tucson, AZ 85719 Yuma – 1235 S. Redondo Center Drive Yuma, AZ 85365 Miami – 2105 E. US Highway 60, Ste. 102 Miami, AZ 85539 Mesa – 702 W. Jerome Avenue Mesa, AZ 85210 Nogales – 1760 N. Mastick Way Nogales, AZ 85621 Phoenix – 16241 N. Tatum Boulevard Phoenix, AZ 85032 Phoenix (South) – 250 N. 7th Avenue Suite 100 Phoenix, AZ 85007 Show Low – 2500 E. Cooley, Ste. 407 Show Low, AZ 85901 Tucson (South) – 88 W. 38th St. Ste. 100 Tucson, AZ 85713 y. Spanish-English Hotline The National Hispanic Family Helpline can link you to clinics and public health programs like KidsCare and AHCCCS as well as give you information on numerous health care topics. Call: (866) SU-FAMILIA OR (866) 783-2645, Monday – Friday 9:00 am- 6:00 pm, Eastern Time. 129 z. Substance Abuse National Clearinghouse for Alcohol and Drug Information (Spanish and English): (800) 662-HELP (4357) or (800) 729-6686 or (301) 984-1471 This toll-free, 24-hour hotline can tell you how and where to get help for alcohol and other drug problems. For more information on substance abuse resources, see the Behavioral Health Resources Section of this binder. aa. Unemployment Unemployment services in Arizona are administered by the Department of Economic Security (DES) – Employment Administration. The Unemployment Insurance Program provides a measure of economic security to workers when unemployment beyond the worker’s control occurs. If you become unemployed and think you qualify for Unemployment Insurance, call: · · · · · · · (602) 364-2722 from Phoenix (520) 791-2722 from Tucson (877) 600-2722 from outside Phoenix or Tucson The system is available Monday – Friday from 8:00 am – 4:00 pm If your Social Security Number ends with 0,1,2, or 3 file your claim on Monday If your Social Security Number ends with 4,5,6, or 7 file your claim on Tuesday Wednesday, Thursday and Fridays are open to all Social Security Numbers It is your responsibility to initiate a claim for unemployment insurance as soon as you become unemployed. You will not receive benefits for any period prior to filing a claim. Arizona Employment Service is a network of public employment offices providing placement services to job seekers. The Job Service focuses on providing a variety of employment related services including: · · · · · · · Job search assistance Job referral and placement assistance Re-employment services. Assessment of skill levels, abilities and aptitudes Career guidance Job search workshops Referral to training For more information about Arizona Employment Service and upcoming Career Fairs contact your local Job Service Office: 130 Job Offices South Mountain/Phoenix – (602) 276-5587 Gilbert – (480) 372-9700 East Valley/Mesa – (480) 962-7678 East Tucson – (520) 584-8226 North Valley/Phoenix – (602) 861-0208 North Tucson – (520) 293-1919 West Valley/Phoenix – (623) 245-6200 South Tucson – (520) 741-7188 Yuma – (928) 247-8740 Bullhead City – (928) 763-4154 Casa Grande – (520) 374-3020 Douglas – (520) 364-8906 Cottonwood – (928) 634-3337 Globe – (928) 425-3101 Flagstaff – (928) 779-4557 Lake Havasu City – (928) 854-0354 Kingman – (928) 753-4333 Page – (928) 645-5201 Nogales – (520) 375-7670 Payson – (928) 468-9800 Parker – (928) 669-6755 Prescott Valley – (928) 277-2600 Prescott – (928) 277-2820 San Luis – (928) 627-9439 Safford – (928) 428-2911 Sierra Vista – (520) 458-9309 Show Low – (928) 532-1516 Eagar – (928) 333-3161 Somerton – (928) 627-9439 Wilcox – (520) 428-2911 Tuba City – (928) 283-5201 Winslow – (928) 289-4644 Window Rock – (928) 871-4131 JobPath is a workforce development program in Tucson and Pima Counties that sponsors underemployed, under-skilled and unemployed adults in training for good jobs with benefits and a career future. Call (520) 324-0402 or (888) 652-3244. bb. Veterans’ Services Arizona Department of Veterans’ Services See www.azdvs.gov The Adult Day Healthcare Center provides adult day healthcare to veterans needing supervision and physical and emotional relief to caregivers. 4141 North Herrera Way Phoenix, AZ 85012 (602) 255-3373 The Arizona State Veteran Home A licensed and skilled nursing facility built to serve the long term needs of veterans. An applicant is eligible for admission if the applicant is a veteran or the spouse of a veteran. The applicant must require skilled nursing care as determined by a physician. 131 4141 W. Herrera Way Phoenix, AZ 85012 Phoenix Area: (602) 248-1550 Outside the Phoenix Area: (800) 406-3373 3333 North Central Avenue, Suite 1052 Phoenix, AZ 85012 From Phoenix Area: (602) 627-3261 From Outside Phoenix Area: (800) 852-VETS Department of Veterans Affairs See www.va.gov. For information of VA Benefits Call (800) 827-1000 Life Insurance (800) 669-8477 Education (GI Bill) (888) 442-4551 Health Care Benefits (877) 222-8387 Facilities in Arizona National Cemetery Administration: Phoenix – National Memorial Cemetery of Arizona - (480) 513-3600 Veterans Benefits Administration: Phoenix – Phoenix Regional Office – (800) 827-1000 Veterans Health Administration Mesa – VA Southwest Health Care Network – (602) 222-6568 Prescott – Northern Arizona VA Health Care System – (928) 445-4860 or (800) 949-1005 Tucson – Southern Arizona VA Health Care System – (520) 792-1450 or (800) 470-8262 Phoenix – Carl T. Hayden VA Medical Center – (602) 277-5551 or (800) 554-7174 Community-Based Outpatient Clinics Bellemont Clinic – (928) 226-1056 or (800) 949-1005 Ext: 7820 Buckeye Clinic – (623) 386-6093 or (888) 214-7264 Casa Grande Clinic – (520) 836-2536 or (800) 470-8262 Cottonwood Clinic – (928) 649-1523 Sierra Vista Clinic – (520) 459-1529 or (800) 470-8262 Green Valley Clinic – (520) 399-2291 or (800) 470-8262 Kingman Clinic – (928) 445-4860 x 6830 or (800) 949-1005 x 6830 Lake Havasu City Clinic – (928) 680-0090 or (800) 949-1005 x 7300 Mesa Clinic – (480) 264-3573 (multiple other numbers also) Payson Clinic – (602) 222-6533 or (888) 214-7264 Safford Clinic – (928) 428-8010 or (800) 470-8262 Show Low Clinic – (928) 532-1069 or (888) 214-7264 Surprise Clinic – (623) 251-2884 Yuma Clinic – (928) 317-9973 or (800) 470-8262 Veterans Centers 132 Phoenix Veterans Center – (602) 640-2981 Prescott Veterans Center – (928) 778-3469 Tucson Veterans Center – (520) 882-0333 cc. Vision Benefits and Services The Lions Club provides assistance with eye examinations, eye surgery and eye glasses. For more information, please call: · · · Lions Vision Center (Phoenix) at (602) 267-7573 or (877) 275-5778 Westside Office (Peoria) (623) 583-9340 Tucson Office (520) 777-7334 Other organizations that can help you identify low or no cost vision services: · · Medical Services Project – call (602) 989-9353 and ask for the Project Manager – calls are accepted based on referrals by school or public health nurses. Vision USA – to be screened in Arizona please call (800) 346-2020 dd. Neighborhood Christian Clinic The Neighborhood Christian Clinic is a 501(c)(3) non-profit medical and dental clinic located in central Phoenix. The clinic serves individuals with no private or public health coverage for a fee of $30 per medical visit or $40 per dental visit. Services include medical and dental visits, prescribed medications, laboratory testing, ultrasound, comprehensive diabetes care, as well as on-site clinics in dermatology, gynecology, and chiropractic care. · · · ee. http://thechristianclinic.org/services/ (602) 258-6008 1929 West Fillmore Street, Building C Phoenix, Arizona 85009 Neighborhood Outreach Access to Health (NOAH) The Scottsdale Healthcare NOAH program operates four school- and community-based clinics in Scottsdale and east/northeast Phoenix, as well as a mobile clinic. NOAH provides primary 133 medical and dental services to underserved/uninsured children and adults. NOAH accepts AHCCCS and offers a sliding fee discount program. Locations: Palomino Elementary School 15833 N. 29th Street, Phoenix (602) 449-2811 Cholla Clinic 11130 E. Cholla Street, Scottsdale (602) 845-4201 Balsz Educare Arizona Center for Health 1350 N. 48th Street, Phoenix (602) 845-4201 Heuser Family Practice Center 7301 E. Second Street, Suite 210 (480) 882-4545 ff. Prescription Drug Benefit – CoppeRx® The Arizona CoppeRx® Card is a prescription drug discount card available to all Arizonans. It can help if you are: · · · · Without health insurance Waiting for insurance to start In need of medication not covered by your health plan Participating in a health savings account plan To sign up, call: (888) 227-8315 There is no cost to enroll in the Arizona CoppeRx® Card Program Average Discounts (actual discounts will vary) · Brand – retail pharmacy – 15% · Brand – mail order – 20% · Generic - retail pharmacy – 35% · Generic – mail order – 55% gg. Prescription Drug Benefit – Coast2CoastRx The City of Phoenix and Financial Marketing Concepts, Inc., are partnering to offer Phoenix residents the Coast2CoastRx card, which provides discounts at pharmacies nationwide. The card is free. For more information, visit http://phoenix.gov/news/111710drugcard.html hh. Pre-existing Condition Insurance Plan (PCIP) Enrollment suspended until further notice, effective March 2, 2013 and will be closing on December 31, 2013. Current enrollees are encouraged to visit the Health Insurance Marketplace to obtain health insurance for 2014 forward. The Pre-existing Condition Insurance Plan (PCIP) 134 provides comprehensive health insurance to those who have been denied insurance due to a preexisting condition, or quoted an extremely high price to keep them from obtaining health insurance. There are no income eligibility requirements, and premiums are not higher based on your medical condition. Several plans are available. To qualify, you must have been without health insurance for at least 6 months. For more information, visit www.pcip.gov. ii. Mission of Mercy Mission of Mercy is a non-profit mobile medical clinic serving uninsured, working poor individuals and families throughout Maricopa County. We provide free primary health care services and no-cost prescription medications at five clinic sites. Avondale Maryvale Phoenix Phoenix Mesa · · · · jj. First Southern Baptist Church of Avondale (1st- 4th Monday of each month) Maryvale Church of the Nazarene (1st & 3rd Tuesday of each month) Holy Family Catholic Church (2nd & 4th Tuesday of each month) Shepherd of the Valley Lutheran Church (every Wednesday) Christ the King Community Center (every Thursday) www.amissionofmercy.org/arizona/locateaclinic.asp 602-486-7798 – Appointment line, all clinics (open Tues from 1:00-6:00 pm & Thur from 9:00 am – 2:00 pm) 623-932-2723 – Appointment line, Avondale clinic only (open Tues & Thur from 9:00 am – 2:00 pm) 602-861-2233 – Administrative Office & Information HIV/AIDS Arizona Department of Health Services (HIV Care and Services) - Services in Arizona are administered through HIV CARE Consortia and direct service contracts. Arizona has four Part B CARE regions; the Northern HIV/AIDS Forum may be contacted at the Arizona Department of Health Services at (602) 364-3610, the Pima County HIV/AIDS CARE Consortium and the Southeastern HIV/AIDS CARE Consortia both facilitated by the Community Foundation for Southern Arizona, (520) 770-0800, and the Western Direct Services region administered by the Yuma County Health Department (928) 317-4580. Although services may vary from region to region because they are based upon local need, some of the services provided include, outpatient medical care, diagnostic testing, dental care, home health care, mental health services, substance abuse services, nutritional counseling and case management. AIDS Drug Assistance Program (ADAP) - The Arizona Department of Health Services (ADHS) is responsible for the administration of ADAP for the state of Arizona. ADAP provides access to medications used to treat HIV and prevent the onset of related opportunistic infections to low-income individuals with HIV disease who have limited or no coverage from private insurance or Medicaid. · (800) 334-1540 135 · www.azdhs.gov/phs/hvstdhpc/adap.htm Care Directions - As one of the recipients of the initial federal Ryan White grant funds in the Phoenix area, Care Directions® has served over 9,000 HIV positive people living throughout Maricopa and Pinal Counties. In addition to serving the general population, specialized case management is provided to women, children, youth, teens and the homeless. The case managers at HIV Care Directions® link clients to medical and pharmaceutical care, transportation, and other services to help them live well with HIV. Case Managers also assess clients’ support systems, finances, and housing and make appropriate referrals to service providers for supportive services, housing programs and benefits assistance. Hours of operation are Monday through Friday 8:00am - 5:00pm. · (602) 264-2273 · http://caredirections.org/ Concilio Latino de Salud – “Concilio Latino de Salud has served the Hipanic/latino communities by promoting education and disease prevention. We are a nonprofit organization which partners with national and local institutions, neighborhoods and individuals. We actively pursue goals set by the national projects "Healthy People 2000" and Healthy people 2010" by providing cross-cultural and bilingual assistance, advocacy, public policy analysis, resources, applied research, client referrals and media links.” · 546 East Osborn Road Suite 22 Phoenix, Arizona 85012 · (602) 285-0970 · http://concilio.org/ Ebony House, Inc. - The Outreach Services Office focuses on a holistic approach to sexual health and wellness through our flagship programs customized to meet the needs of our target demographic. Our advanced outreach specialists focus their efforts on African Americans and those at high risk residing in metropolitan Phoenix through the provision of one-on-one interventions, group counseling, and HIV testing. We offer highly supportive services to persons living with HIV/AIDS through our Ryan White Part A/MAI Outreach and Non-Medical Case Management program. The newest addition to our service roster, SISTA, is an HIV prevention intervention targeting Black women ages 18-54. The hallmark of our services is a focus on the whole person, developing self-esteem and self-efficacy in all of our clients through loving, supportive intervention. · 6222 S. 13th Street Phoenix, AZ 85042 · (602) 276-4288 · http://ebonyhouseinc.org Jewish Family and Children’s Service – “Our staff provides initial assessments, psychiatric assessments if necessary, psychiatric medications management, individual and couples/family counseling and assistance in locating other necessary medical and social services. These services are available at the JFCS behavioral health sites in Phoenix, Glendale and Mesa.” · (602) 256-0528 · http://www.jfcsaz.org/site/c.ajIQK6NMLfJ0E/b.6493393/k.C456/HIVAIDS.htm 136 L.U.C.E.S. (Latinos Unidos Contra El Sida/ Latinos United Against AIDS) – A program of Chicanos por la Causa, the “L.U.C.E.S program has provided HIV supportive services to hundreds of people living with HIV/AIDS. It also provides HIV education/resources to thousands of at-risk Latinos in Maricopa and Pinal Counties. “ · 4602 West Indian School Road, #C3 Phoenix, AZ 85031 · (623) 247-0464 · http://www.cplc.org/social-services/hiv-education-prevention.aspx McDowell Healthcare Center – “Services provided at the center include primary medical care, dental care, HIV testing and counseling, behavioral health care, and clinical trial research for new drug therapies, and support services. All medical and dental services, including urgent care, are provided by appointment only. The clinic is open from 8am to 5pm, Monday through Friday, except holidays.” · 1144 E. McDowell Rd., Suite 300 Phoenix, AZ 85006 · (602) 344-6550 · http://www.mihs.org/facilities/mcdowell-healthcare-center Phoenix Children's Hospital Bill Holt Clinic – “The Bill Holt Clinic at Phoenix Children's Hospital is the only comprehensive pediatric HIV clinic in the state of Arizona, providing comprehensive care for children and adolescents exposed to or infected with HIV.” · 1919 E. Thomas Road Phoenix, AZ 85016 · (602) 933-1000 · http://www.phoenixchildrens.com/medical-specialties/bill-holt.html Phoenix Indian Medical Center HIV Center of Excellence – “The primary goal of the HIV Center of Excellence is to provide the highest quality of culturally competent HIV services for American Indians and Alaskan Natives including clinically based prevention, intervention, and medically appropriate HIV care and treatment.” · Phoenix Indian Medical Center 4212 North 16th Street Phoenix, AZ 85016 · 1-866-243-3182 · http://www.ihs.gov/MedicalPrograms/aids/index.asp Phoenix Shanti Group – “The mission of the Phoenix Shanti Group is to provide housing, education and direct client services to individuals, families and loved ones infected with and affected by HIV / AIDS.” · 2345 W. Glendale Ave. Phoenix, Arizona 85021 · (602) 279-0008 · TDD (800) 367-8939 · http://www.shantiaz.org/ Southwest Center for HIV/AIDS – “The Southwest Center for HIV/AIDS provides these services in a nurturing environment: · Leading-edge medical research through the largest privately funded, nonprofit, HIV clinical trials site in the Southwestern United States. 137 · · · · · · · · · Education programs, including group and individual instruction for men, women and youth infected or affected by HIV/AIDS. HIV prevention programs for men, women, youth, and transgender individuals. Wellness services, including nutritional consultants, naturopathic medicine and an on-site vitamin shop. Emotional support for HIV-positive individuals, their friends and families. Family support services, including child watch, family camp and social activities for families living with HIV/AIDS. Community outreach, reaching out to underserved populations and providing connection to HIV services.” 1144 East McDowell Road Suite 200 Phoenix, AZ 85006 (602) 307-5330 http://www.swhiv.org/ Terros (HIV/STI Prevention) – “The Together Program’s HIV/STI Prevention Services provide testing, education and outreach for people at risk or currently infected with HIV or syphilis. Our goal is to help individuals protect themselves, prevent the spread of disease, and reduce substance abuse which often contributes to risky behaviors.” · 1029 North First Street Phoenix, AZ 85004 · (602) 685-6086 · http://www.terros.org kk. Crews’n Healthmobile “In the fall of 2000, an innovative partnership was formed between Phoenix Children's, Children's Health Fund and HomeBase Youth Services. The result was named the Crews'n Healthmobile, a 35-foot Mobile Medical Unit (MMU) that brought free, comprehensive medical help directly to this special population. In October 2007, the Crews'n Healthmobile II hit the streets. This 38-foot MMU is outfitted with three exam rooms and the latest technology. While visiting the Crews’n Healthmobile, new patients received mental health (depression, anxiety, and mood disorder), health risk and physical health screening. Healthcare providers (physicians and nurse practitioners) treated patients and dispensed medications for a variety of conditions ranging from minor surgical procedures, basic blood work, upper respiratory illnesses, skin infections, fractured bones, strained and sprained extremities, sexually transmitted illnesses, asthma, influenza, dehydration, chest pain with ECG changes, diabetes, obesity, hypertension, depression and pregnancy.” Criteria for Admission · · · Pediatric children, adolescents and young adults up to 24 years of age who state they are homeless or at risk of being homeless Patients are eligible for services, regardless of insurance status and/or ability to pay There is no charge for services, they are free. 138 Crews'n Healthmobile Phoenix Children's Hospital 3333 E. Van Buren St. Phoenix, AZ 85008 (602) 651-1862 http://www.phoenixchildrens.com/ 139 XIII. Tools 140 XIII. Tools a. AHCCCS Income Eligibility Limits For the most recent list of income eligibility limits for AHCCCS programs, see: http://azahcccs.gov/community/Downloads/resources/EligibilityRequirements.pdf These limits are adjusted annually when the federal government changes the federal poverty limit guidelines. The limits are different for each AHCCCS program. 2014 Poverty Guidelines for the 48 Contiguous States and the District of Columbia (http://aspe.hhs.gov/poverty/12poverty.shtml) Persons in Poverty Guideline family/household 1 $11,670 2 15,730 3 19,790 4 23,850 5 27,910 6 31,970 7 36,030 8 40,090 For families/housholds with more than 8 persons, add $4,060 for each additional person. -The poverty guidelines usually are updated in the spring of each year. 141 b. AHCCCS Program Eligibility Coverage for Children Program Income Qualifications Special Requirements Benefits SOBRA Up to 147% of AHCCCS Medical For Children Federal Poverty N/A Services <1 yr Level (FPL) SOBRA Up to 141% of AHCCCS Medical N/A For Children from FPL Services ages 1-5 SOBRA Up to 133% of AHCCCS Medical N/A For Children ages FPL Services 6-18 Note: To be eligible the child must be US Citizen or Eligible Qualified Non-Citizen (see Citizenship section of this binder for more information). Coverage for Families or Individuals Program AHCCCS for Families and Children* Income Qualifications Up to 133% of Federal Poverty Level (FPL) Special Requirements · Family includes a child Benefits AHCCCS Medical Services AHCCCS Care · Ineligible for any other Up to 133% of AHCCCS Medical For Individuals or categorical Medicaid FPL Services Married Couples** Coverage Young Adult Transitional · Under age 26 AHCCCS Medical Insurance N/A · Child was in DES Foster Services For Young Adults Care when became 18 leaving Foster Care Note: To be eligible, patient must be US Citizen or Eligible Qualified Non-Citizen (see Citizenship section of this binder for more information). * Governor Brewer has proposed a freeze on enrollment for parents between 75-100% FPL effective October 1, 2011. However, this requires federal approval and is pending litigation. Anyone who feels they may be eligible should still apply. **AHCCCS has scheduled a freeze in enrollment for adults without dependent children effective July 1, 2011. This will lift effective January 1, 2014. Those enrolled before that date would still be allowed to renew their coverage if they comply with all renewal requirements. Coverage for Women Program SOBRA For Pregnant Women Income Qualifications Up to 150% of Federal Poverty Level (FPL) Special Requirements · Proof of pregnancy 142 Benefits AHCCCS Medical Services Program Income Qualifications Special Requirements · · · Breast and Cervical Cancer Treatment Program For Women Up to 250% of FPL · Under age 65 Uninsured Screened and diagnosed with breast cancer, cervical cancer, or a precancerous cervical lesion by the Well Women Health Check Program Ineligible for any other Medicaid coverage Benefits AHCCCS Medical Services Note: To be eligible patient must be US Citizen or Eligible Qualified Non-Citizen (see Citizenship section of this binder for more information.) Coverage for Medicare Beneficiaries (Medicare Cost Savings Programs) Program Qualified Medicare Beneficiary Income Qualifications Up to 100% of Federal Poverty Level (FPL) Special Requirements · Entitled to Medicare Part A Benefits Payment of Part A and B premiums, coinsurance, and deductibles · Entitled to Medicare Part A Payment of Part B · Not receiving Medicaid premium benefits · Entitled to Medicare Part A Payment of Part B 120% - 135% of Qualified Individual FPL · Not receiving Medicaid premium Benefits Note: To be eligible patient must be US Citizen or Eligible Qualified Non-Citizen (see Citizenship section of this binder for more information). Specified Low-Income Medicare Beneficiary 100% - 120% of FPL ***AHCCCS Medical Benefits include, but are not limited to, doctor’s office visits, immunizations, hospital care, lab, x-rays, and prescriptions. 143 Coverage for the Elderly or People with a Disability Income Program Special Requirements Qualifications · Requires nursing home level of care or equivalent Arizona Long Term Up to 300% of Care System · May be required to the Supplement (ALTCS) pay a share of the cost Security Income For Adults or · Estate recovery Rate Children program for the cost of services received after age 55 Up to 100% of · Age 65 or older, SSI Medical Federal Poverty blind, or with a Assistance Only Level (FPL) disability Up to 250% of · Must be working and FPL countable either have a AHCCCS income (only disability or blindness Freedom to Work earned income is · Must be age 16 counted) through 64 · Must be receiving Social Security Disability No income limit, · Must have received but must be AHCCCS health SSDI Temporary willing to pay insurance within the Medical Coverage – monthly past 24 months, but premiums based ELIMINATED no longer qualify on household · Cannot reside in a income and size penal institution or institution for mental disease Benefits AHCCCS Medical Services, Nursing Facility, Home and Community Based Services, and Hospice AHCCCS Medical Services AHCCCS Medical Services AHCCCS Services Note: To be eligible patient must be US Citizen or Eligible Qualified Non-Citizen (see Citizenship section of this binder for more information.) 144 AHCCCS System Enrollment Process Obtain an Application from AHCCCS, DES, or community application sites Mail-in your application or bring it in to a Federally Qualified Health Center, AHCCCS or your local DES office where it will be screened Applicant Receives Health Insurance! Not Eligible Applicant or parent notified Some programs require a face-to-face interview Eligibility is determined through verification of documents Enrolled If you are eligible you will be assigned to the health plan you indicated on the AHCCCS application 145 c. How to Apply for AHCCCS Programs There are several ways you can apply for AHCCCS Programs: · Through your local Federally Qualified Health Center (FQHC) (“Community Health Centers”); · Through AHCCCS; · Through enrollment assistance partners · The Your Health Hotline in Pima and Santa Cruz Counties and 211 hotline · The Kids Health Link group and the 211 hotline · Through the Department of Economic Security (DES); · Through medical discount programs such as HealthCare Connect, the Pima Community Health Access Program; · For AHCCCS Freedom to Work, apply directly to the AHCCCS Freedom to work unit at (602) 417-6677 or (800) 654-8713. · Through the Navigators and Assisters 1) Through your local Community Health Center (CHC) If you go to your local FQHC there will be a person there to help you fill out the online application for AHCCCS Health Care Programs called the “Health-e-Arizona” Application. They will assist you in filling out the application and submitting it online. See the Community Health Center Section in this document for more information. You may get better service if you call your local Health Center first and make an appointment to fill out your AHCCCS application. 2) Through AHCCCS There is one application to submit for all AHCCCS health insurance programs. You can get the application: · On the AHCCCS website at www.ahcccs.state.az.us · Picking up the application from community organizations, school nurses, community clinics, or local hospitals or calling 211 to get assistance with filling one out · Print a copy from AHCCCS Website or complete the application online at www.healthearizonaplus.gov. Follow the instructions on the second page of the application, and, to speed up processing of your application, send the information requested with your application. 146 You can get help filling out your application between 8 am and 5 pm, Monday through Friday by calling (602) 417-5010 or (800) 528-0142 then pressing 11. If you are applying for children or children and adults, mail your application and other required information to: 701 East Jefferson MD 7500 Phoenix AZ, 85034 If you have questions or need an interpreter you can call (602) 417-5437 or toll free at (877) 764-5437 If you are applying for aged, blind or adults with a disability only, mail your application and other required information to: 801 East Jefferson MD 3800 Phoenix, AZ 85034 If you have questions or need an interpreter, you can call (602) 417-5010 or toll free at (800) 528-0142 3) Through the Department of Economic Security (DES) At DES you can complete an “Application for Cash Assistance, Food Stamps, and AHCCCS Health Insurance.” You can get the application: · On the DES website at www.azdes.gov · At your local DES office (for a list of DES Offices see the DES section of this document) · Apply for benefits on-line at http://www.healthearizonaplus.gov Federally Qualified Health Centers Facilitating Health-e-Arizona Applications Note: This list is not inclusive of all “satellite sites” which may also complete Health-eArizona Applications; please call the Federally Qualified Health Center in your area to find out which site or “satellite site” is closest to you. 147 FQHC Address Canyonlands Community Health Center (Coconino, Mohave, Navajo, Apache Counties) Chiricahua Community Health Centers, Inc. (Cochise County) Clinica Adelante, Inc. (Maricopa County) Desert Senita (Pima County) El Pueblo Health Center, Inc. (Pima County) El Rio Health Center (Pima County) Marana Health Center (Pima County) Mariposa Community Health Center (Santa Cruz County) Mountain Park Community Health Center (Maricopa County) Native American Community Health Centers, Inc. (Maricopa County) North Country Community Health Center (Coconino County) St. Elizabeth Health Center (Pima County) 427 Vista Avenue Page, AZ 86040 10566 North Highway 191 Elfrida, AZ 85610 16551 N. Dysart Road, #104A Surprise, AZ 85374 410 Malacate Street Ajo, AZ 85321 101 West Irvington Road, #A1 Tucson, AZ 85714 839 West Congress St. Tucson, AZ 85745 11981 W. Grier Road Marana, AZ 85653 1852 N. Mastick Way Nogales, AZ 85621 635 E. Baseline Road Phoenix, AZ 85042 4520 N. Central Avenue, 3rd Floor Phoenix, AZ 85012 2920 N 4th Street Flagstaff, AZ 86004 140 W. Speedway Boulevard Suite100 Tucson, AZ 85705 865 N. Arizola Road Casa Grande, AZ 85222 115 N. Somerton Avenue Somerton, AZ 85350 1260 S. Campbell Road Green Valley, AZ 85614 Sun Life Family Health Center (Pinal County) Sunset Community Health Center (Yuma County) United Community Health Center (Pima County) Phone (928) 645-8123 (520) 642-2222 (623) 546-2294 (520) 387-5651 (520) 670-3909 (520) 670-3909 (520) 682-4560 (520) 281-1550 (602) 243-7277 (602) 279-5262 (928) 213-6100 (520) 628-7871 (520) 836-3446 (928) 627-2051 (520) 407-5400 d. Tips for Completing Your AHCCCS Application If you are applying for you, your spouse, or your children (younger than age 19), include information about yourself and everyone who lives with you and is: · Your spouse · Your child (includes stepchild) · Your child’s children · Your child’s spouse · Your child’s other parent · Your parent(s) if you are under age 19 · A child related to you who you are caring for · A child age 19 to 21 who is a student 148 Include a person who normally lives with you but is temporarily not living with you because the person is working or is a child attending school. If someone included on your application is pregnant, be sure to indicate this. For some programs, children who are not yet born are counted as household members. If you are applying for someone not listed above, include the persons who are related to the person for whom you are applying. The person for whom you are applying needs to either sign the application on page 7 or complete section F on page 1. Send the information listed below with your application to speed up processing: · · · · · · · · Wages: Copies of check stubs or a statement from the employer showing the gross earnings last month and this month of everyone listed on the application. If someone listed on the application lost a job within the last two months, send proof of the last day worked and the gross amount of the last check received. Self-Employment: Copies of current Federal Tax Forms and applicable schedules or proof of business income and expenses for the last calendar month. Child Support: Copies of the court order or child support payment history. Other Income: Proof of any other income or money received this month and last month from any source or for any reasons. Health Insurance: Copies of insurance ID cards for persons who are applying, but who are currently covered by other health insurance. Daycare: Proof of amount billed for care of a child or incapacitated adult so an adult in the household can work. Pregnancy: A signed letter from your doctor or nurse giving the expected date of delivery. Health Plan: Choose a health plan from the choices on the application. If you are applying for the first time, the items listed below MAY be needed to determine your eligibility. If you need help in obtaining any verification, please ask your Eligibility Interviewer, who will assist you: · · · · · · · · · · Proof of identity Social Security numbers or proof that a Social Security number has been applied for Birth Certificates or other proof of citizenship Alien Registration Cards, if there are non-U.S. Citizens in your household Name, address and daytime phone number of landlord or neighbor Proof of any money your household received from any source in the last 30 days Registration/titles for all vehicles Bank or credit union (savings or checking) statement for the more recent month Proof of pregnancy Proof of childcare expenses for the most recent month (if you want to receive a deduction) 149 · Proof of medical expenses, if you are age 60 or older, or receive Social Security Disability, SSI, Railroad Retirement, or disability pension from a government agency (if you want to receive a deduction) e. How to Renew your AHCCCS Coverage KidsCare · Renewal of benefits is required every 12 months. · Fill out a KidsCare Renewal Application – this application is shorter than the initial application. · For more information about renewing your KidsCare Coverage call (602) 417-5437 or (877) 764-5437, visit a community assister or Federally Qualified Health Center (listed in this document), call 211 or visit www.healthearizonaplus.gov. Medicaid · Renewal of benefits is required every 12 months, with some exceptions requiring a review at 6 months. · Fill out a DES “Application for Cash Assistance, Food Stamps, and AHCCCS Benefits” or an AHCCCS renewal form. · For more information on renewing your coverage call (602) 417-5010 then press 11 or (800) 528-0142 then press 11. You may also visit a community assistor or Federally Qualified Health Center (listed in this document), or visit www.healthearizonaplus.gov. f. How AHCCCS Health Plans Work Picking an AHCCCS Health Plan · · · When you fill out your AHCCCS Application you need to choose a health plan that serves your county from the list on Page C of the Application. If you do not choose a health plan one will be assigned to you. Before choosing, check with your doctor, hospital or pharmacy to see if they work with the plan that you want. How do the Plans Work? · · · · · An AHCCCS Health Plan is like a Health Maintenance Organization (HMO). Your health plan will send you a member handbook once you are enrolled. You must choose your primary doctor or one will be assigned to you; you will get a list of primary doctors from your health plan. You have the right to change your primary doctor at any time. Your primary doctor will: o Take care of your health care 150 · o Be the first person you go to for non-emergency medical care o Be responsible for coordinating your non-emergency medical services o Send you to a specialist when needed If you need behavioral health services you can be referred through your primary doctor or call the behavioral health telephone number on your AHCCCS Card. Eligible for AHCCCS Program Choose or be assigned to AHCCCS Health Plan Primary doctor will refer you to specialists as needed (pharmacy, laboratory, x-ray, specialty care, home health, family planning, etc) For behavioral health services call number on AHCCCS Card See primary doctor for nonemergency medical care Receive member handbook from health plan g. Citizenship Requirements To be eligible for AHCCCS Medical Services, the customer must be a citizen of the United States or an eligible Qualified Non-citizen. Who is eligible for AHCCCS Medical Services? 1. A Citizen · Citizen by Birth – a person born in the United States or a U.S. territory 151 · · · · Citizenship Through U.S. Parent – a person born outside the U.S. to a parent who is a U.S. citizen if certain conditions are met Citizenship Through Marriage – a woman who married a U.S. citizen before September 22, 1922 (does not apply to a man who married a U.S. citizen) Citizenship by Naturalization – a person who has applied for and gone through the naturalization process to become a U.S. citizen Dual Citizenship – a person may be a U.S. citizen and a citizen of another country, dual citizenship status does not affect U.S. citizenship Most AHCCCS customers will need to provide proof to establish their identity and citizenship. Proof of citizenship includes naturalization certificates, passports and original birth certificates. 2. An Eligible Qualified Non-citizen · Qualified Alien – A person admitted to the U.S. legally in a specific classification; some, but not all qualified aliens meet the requirement for full AHCCCS coverage. 3. Who is NOT eligible for AHCCCS Medical Services? · Non-Qualified Alien – a person admitted to the U.S. legally, but not in one of the qualified alien classifications; does not meet requirement for full AHCCCS coverage, but may be determined eligible to receive emergency medical services. · Undocumented Alien – a person who is in the U.S. without the permission of the U.S. government; does not meet requirement for full AHCCCS coverage, but may be determined eligible to receive emergency medical services. 4. Benefits Available for Non-Qualified Aliens · · · Federal Emergency Services State Emergency Services Children of non-citizen parents ARE eligible for KidsCare and AHCCCS if the children are citizens and meet other eligibility criteria. The U.S. Citizenship and Immigration Service (formerly INS) has stated clearly that the use of non-cash benefits like KidsCare will not hurt a family’s immigration status. Document your U.S. citizenship & identity with: List #1 United States (U.S.) Passport Most Reliable U.S. Naturalization Certificate issued by U.S. Citizenship & Immigration Services (USCIS) Certificate of Citizenship issued by USCIS 152 Document your U.S. citizenship with: U.S. Birth Certificate Certification or Report of Birth Abroad issued by USCIS or the State Department U.S. Citizen ID card issued by USCIS American Indian card issued by USCIS for the Kickapoo tribe List #2 Final Adoption Decree Evidence of Civil Service employment by U.S. Government before 6/1/1976 Official Military Record of Service showing U.S. place of birth (i.e. a DD-214) Northern Mariana ID card issued by USCIS to a naturalized citizen born before 11/4/1986 Extract of U.S. hospital birth record established at the time of birth List #3 Life, health, or other insurance record showing U.S. place of birth (Either of these must have been created at least 5 years before the initial AHCCCS application date.) List #4 Least Reliable Census records showing U.S. place of birth Nursing home records, medical records, or other documents showing U.S. place of birth created at least 5 years before initial AHCCCS application date Bureau of Indian Affairs tribal census records (Navajo & Seneca tribes only) Written affidavit (see eligibility specialist for details) Document your identity with: Driver's License Certain government issued ID cards with photo (if no photo, must include identifying information) Tribal government issued ID and documents, including Certificate of Indian Blood Day care or nursery record (minors only) School record or report card (under 16 only) School ID with picture U.S. Military ID, U.S. Military Dependent ID or U.S. Military Draft Record (over 16 years only) U.S. Coast Guard Merchant Mariner Card Affidavit (under 16 only) 153
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