Crisis Response Network, Inc. (CRN) is responsible for reviewing all applications for SMI services and making these determinations for the state of Arizona.

A person can request to be evaluated/considered for SMI services. The person must make a request through their provider or their T/RBHA. When a request is made, the provider/T/RBHA will then complete an evaluation and an SMI Assessment Packet for each person. The Provider will then send the completed SMI Assessment Packet to CRN. CRN will then review the packet and determine whether the individual is eligible for SMI services by following the State’s guidelines/criteria.

CRN follows the State’s guidelines/criteria to determine SMI eligibility:

  • The person has a qualifying diagnosis (mental illness) as described in the T/RBHA Provider Manual: SMI Qualifying Diagnosis section; and
  • The person experiences serious functional dysfunction as a result of that diagnosis (the person has trouble with day-to-day activities or interactions). This includes social, occupational and psychological functioning of adults, e.g., how well or how flexible a person is when meeting different day-to-day problems.
  • The person does not currently experience serious functional dysfunction but may be expected to deteriorate to such a level without treatment.

The provider and or T/RBHA must complete an assessment within seven (7) days after the request is made. The provider or T/RBHA then sends the completed packet to CRN within one (1) business day.

CRN has three (3) days after receiving the packet and all the information they need to review and make a decision (determination) about whether the person is eligible for SMI services. CRN must make a decision based on the information we get from the provider or T/RBHA. This means that if information is missing or a packet is not complete CRN may determine that you are not eligible for SMI services (this mostly happens when CRN does not receive records from past providers).

You can chose to forfeit your right to a decision in three (3) days to give providers more time to send CRN all of the information we need to make the best decision. You have two choices:

  • Pending (or extending) the SMI eligibility determination for 20 days. CRN can still make the decision before the 20 days once we receive all the necessary information.
  • If you agree to it, the SMI eligibility determination process can be extended up to 90 (calendar) days for an Extended Evaluation Period (EEP): This is a 90 day period of abstinence from drug and/or alcohol abuse in order to help the reviewing psychologist make an informed decision regarding SMI eligibility.

CRN will send you a letter by mail to let you know what the final decision on your SMI determination is. This letter is called a Notice of Decision. If CRN finds that you are not eligible for SMI services, the letter will tell you why. If you do not get the letter/notice by the end of the time you agreed to (three (3), 20 or 90 days), please call CRN at 855-832-2866.

If your letter says that you DO qualify for SMI services, CRN will notify Arizona Health Care Cost Containment System (AHCCCS), the T/RBHA and your provider.

Step 1

An individual, their guardian, designated representative or family member can ask his/her current AHCCCS provider –or– they can call the T/RBHA to ask for an SMI Determination.

Step 2

An evaluation is required to occur no later than seven days after a request is made.

Step 3

The individual meets with a qualified assessor.

Step 4

The assessor sends the required paperwork (assessment) to CRN.

Step 5

CRN has either three, 20, or 90 days to make the determination depending on each individual case.

Step 6

After a decision has been made, a notice is sent to the individual with the results (determination) and how to receive services (when applicable).

Step 7

Each applicant has the right to appeal their SMI determination.

Step 8

To appeal, an individual must fill out and send the appeal form and include the original determination (decision). Or, they can call CRN and file by phone at 855-832-2866.

Step 9

The individual will be able to meet with a second reviewing psychologist in an informal meeting within seven days of filing the appeal. Any additional information about the individual’s treatment history will be considered.

Step 10

CRN will make the second decision within three to 20 days depending on the need for more information.

Step 11

The individual will get a notice in writing with the final decision.

Step 12

If the individual wishes to appeal the second decision, they have the right to ask for an administrative hearing.

person-5

The Crisis Specialist walked us through the scariest time of our family’s life.

– Family Member

What does it mean to be determined SMI or eligible for SMI services?

Serious Mental Illness (“SMI”) is a description used in Arizona for people who need additional support because their mental illness impacts their ability to function.

What is looked at (criteria/qualifications) to diagnose someone or determine if they qualify for SMI services?

To be eligible for SMI services (to get an SMI determination) a person must have both an SMI diagnosis and functional impairment caused by the qualifying diagnosis.

How do I request/ask for an evaluation for SMI services?

If you are would like to be assessed for SMI services, please call your provider or local T/RBHA. Your T/RBHA or provider will then arrange for a qualified assessor to meet with you and complete an application for SMI services.

Northern Arizona:

Central Arizona:

  • Mercy Maricopa Integrated Care
    1-866-602-1979 (toll‑free)
    Hearing impaired TTY/TDD 711

Southern Arizona:

If you are already receiving services with an AHCCCS provider, you may ask your provider to submit an application for SMI services.

If you are a provider, you may submit applications through this website on the SMI Assessment Submission Portal page.

What if I don’t want SMI services anymore?

SMI services are voluntary. You may choose not to receive services. Or, you can ask your clinical team about closing or dis-enrolling.

Have a question?
Contact us

The best way to make sure that the SMI Determination is done right and as quickly as possible is for you to be prepared. If you can, have as much information with you as possible to the SMI evaluation meeting. Things that are helpful are:

  • a list of any past behavioral health providers (school IEP’s, doctors, hospitalizations, therapists, etc.) with their name, address and telephone number;
  • the evaluator will ask you to a complete release of information (ROI) so that they can request medical records from each of the past providers; and
  • copies of complete records, if available. Often family members can help you with this piece and will have this information.
  • You should know that you can bring friends and/or family to the first assessment meeting. Family members can help by giving additional background information about symptoms and functional impairment.

The letter (SMI Notice of Decision) that Crisis Response Network will send you will include information on your rights to appeal the decision if you do not agree with the SMI eligibility determination. Applicants have 60 days from the date of the decision to appeal the decision. The letter will also include a form that can be completed and mailed to CRN to file an appeal, or you can appeal by phone by calling CRN at 855-832-2866.

After an appeal has been received, CRN will schedule an informal meeting with you to discuss your SMI eligibility determination and review any new records or information that may impact the SMI eligibility determination. If, after the informal meeting, CRN determines you do not meet SMI criteria, you then have the right to request an Administrative Hearing with an Administrative Law Judge. Requests for Administrative Hearings must be made in writing and sent to Arizona Health Care Cost Containment System (AHCCCS) at the following address:

AHCCCS/OALS
Behavioral Health Grievance and Appeals
701 E. Jefferson Street, Mail Drop 6200
Phoenix AZ 85034