NORTHPOINTE BEHAVIORAL HEALTHCARE SYSTEMS
POLICY TITLE: Wait List
MANUAL: Clinical
ORIGINAL EFFECTIVE DATE: 10/2/95
REVIEWED/REVISED ON DATE: 4/16/15
REVISIONS TO POLICY STATEMENT:
YES
NO
PAGE: 1 of 3
SECTION: Entry to Care
BOARD APPROVAL DATE: 9/26/13
CURRENT EFFECTIVE DATE: 5/1/14
OTHER REVISIONS:
YES
NO
APPLIES TO:
All Non-Medicaid service recipients.
POLICY:
To have written policies/procedures that address waiting list management in accordance with Michigan Department of
Community Health.
PURPOSE:
It is policy that individuals requesting services are seen in a prompt manner. When an individual expresses a need
that would be considered urgent or emergent, Northpointe will stabilize the crisis situation. Following stabilization,
the individual shall be assessed for further needs. Requests will be met according to medical necessity/level of care
criteria. Should the need arise; NorthCare Access Screening Dept. will maintain a wait list for admission into
Northpointe. Eligible Medicaid individuals shall be admitted and not placed on a wait list. While it is the policy of
the MDCH that the overall purpose of the public mental health system is to provide necessary services to all
individuals with mental health needs, it is also recognized that funds may be insufficient to address the needs of all
individuals desiring to receive services from the public mental health system. Thus NBHS may need to prioritize
who receives public mental health services, and when it cannot address all local needs, establish a waiting list
according to documented processes that ensure systematic access into services and on-going service delivery.
PROCEDURES:
Should an unexpected increase in demand for services occur that cannot be absorbed with current resources the
populations served would be processed as follows:
1. If, upon completion of an initial assessment, a service is not available, the provider will also complete a
Discharge/Transfer Summary Form, Medical Services Referral Form, or the ELMER Specialty Discipline
Referral Form and forward to the appropriate Site Supervisor/CEO to inform them of this need.
2. Master’s Level Site Supervisors/CEO will enter this information on the Agency Wait List on Shared Drive,
which will be monitored by the Clinical Site Directors
3. Applicants for services who are placed on a waiting list (un-served) must receive written notice within
3 business days, including the following:
 Service for which the individual is on the waiting list
 Instructions on what the individual should do if his/her situation changes, including obtaining Medicaid
coverage
 The individual’s right to have the decision reviewed
4.
The order of priority on the waiting list shall be based on the individual’s severity and urgency of
need, and the time/date of request for services. If two or more persons are of equal severity and
urgency, priority will be given to the person who requested services first. The individual’s
prioritization on the wait list shall be based on the following information and criteria (each of the
following factors must be documented):
a)




Adults with Serious Mental Illness (SMI)
Severity of mental illness
Severity of functional impairment(s)
Domains in which there is an impairment
Risk Factors/Degree of Risk
NORTHPOINTE BEHAVIORAL HEALTHCARE SYSTEMS
POLICY TITLE: Wait List
PAGE: 2 of 3
MANUAL: Clinical
SECTION: Entry to Care
ORIGINAL EFFECTIVE DATE: 10/2/95
BOARD APPROVAL DATE: 9/26/13
REVIEWED/REVISED ON DATE: 4/16/15
CURRENT EFFECTIVE DATE: 5/1/14
 Existence of complex, co-occurring conditions, such as SUD or significant medical conditions
(additive to mental illness)
 Priority may be mitigated by other available options, such as community resources, other insurance
payers, natural supports, etc.
b)
c)
Children with Serious Emotional Disturbance (SED)
Severity of emotional disturbance
Severity of functional impairment(s)
Domains in which there is an impairment
Risk Factors/Degree of Risk
Existence of complex, co-occurring conditions, such as SUD or significant medical condition
(additive to mental illness)
 Developmental profile/status
 Stability of living situation, to include consideration of a primary caregiver with a serious mental
illness or complex situation
 Priority may be mitigated by other available options, such as community resources, other insurance
payers, natural supports, etc.





Persons with Intellectual/Developmental Disabilities (I/DD)
Severity of development disability
Severity of functional impairment(s)
Domains in which there is an impairment
Risk Factors/Degree of Risk
Existence of complex, co-occurring conditions, such as SUD or significant medical condition
Stability of living situation, to include consideration of a primary caregiver with a serious mental
illness or complex situation (e.g. health risks)
 Priority may be mitigated by other available options, such as community resources, other insurance
payers, natural supports, etc.






5. A single integrated waiting list will be maintained by NBHS and will include the required information
specified in the Technical Advisory. Lists will include:
a) All “unserved” Mental Health Code defined priority persons which include: (i) any person who
cannot immediately access necessary mental health services in a timely manner; and (ii) any active
service recipient who has had their services denied, suspended or terminated.
b) All “underserved” which includes: (i) any active service recipient who had had their services
reduced due to non-clinical reason whereby the recipient is no longer receiving necessary services
that are sufficient in scope, amount, quantity or duration; and (ii) any new applicant who has had
any necessary services limited in amount, scope or duration.
6. A Master’s prepared PIHP access clinician will coordinate with NBHS to review the waiting list on a
regular basis, but at least quarterly. Review activities shall be documented and shall minimally include:
a) Removal of names of persons served;
b) Removal of names of persons who request to be removed from the waiting list;
c) Addition of new names placed on the waiting list and the (re)-prioritization of the overall list, if
necessary;
d) Re-prioritization of the waiting list according to an individual’s changing urgency and severity
of needs;
e) Documentation of the reasonable attempts to contact individuals (i.e.: phone, US Postal
Service), to determine if they wish to stay on the list, or if they have experienced any change in
situation.
NORTHPOINTE BEHAVIORAL HEALTHCARE SYSTEMS
POLICY TITLE: Wait List
PAGE: 3 of 3
MANUAL: Clinical
SECTION: Entry to Care
ORIGINAL EFFECTIVE DATE: 10/2/95
BOARD APPROVAL DATE: 9/26/13
REVIEWED/REVISED ON DATE: 4/16/15
CURRENT EFFECTIVE DATE: 5/1/14
7. Priority lists for each service needing a wait list will be made by logging the following information for each
individual:
a) Name and age of the individual;
b) Type of service being requested and diagnosis;
c) Location of requested service
d) Date of the initial request for service;
e) Current provider & location of service;
f) Severity/urgency of need.
8. This information is incorporated into Northpointe’s Program Planning Guideline submission, into the
ongoing planning process, and in the organization’s information management system.
REFERENCES
MDCH Technical Advisory: Guidelines for Establishing and Managing General Fund Waiting Lists
MDCH/PIHP Contract Attachment P.3.1.1, Access Standards