Painted Hills 3

 

Definitions

Acute Inpatient Psychiatric Care: Care you receive in a hospital. We must approve this type of care.


Appeal: To request a review of your grievance, service request, service changes or service authorizations.


Case Management: Services to help you get care from other agencies.


Consultation: Advice given from one professional to another involved in your care.

Daily Structure and Support: Programs to help you with daily tasks or to live in the community. They also help you get along with other people.


Emergency Services: A behavioral health problem that cannot wait until the following day, which requires immediate attention or will jeopardize the health of the GOBHI member.

Evaluation: A way to decide your need for behavioral health services.


Excluded Services: Behavioral health services that are not covered. You may have to pay for these services. You will have to pay if you know the services are excluded and you accept the care anyway. This includes any service provided in an emergency care setting that is not an emergency.

Grievance: An expression of dissatisfaction that includes a
desired resolution.


Interpreter Services: Language or sign interpreters for persons
who do not speak the same language as the provider or for
persons who are hearing impaired.


Job Opportunities and Basic Skills (JOBS) Treatment: Programs that help you function better in employment settings. Limited Services: Behavioral health services that are only partly covered. You may have to pay for these services. You will have to pay if you know the services are limited and you accept the care anyway. This includes services that go beyond those needed to find out what is wrong.

Post-Stabilization Care Services: Care services you receive after a behavioral health emergency to improve condition.

Medical Health Plan: A health plan that contracts with the Oregon Health Authority (OHA). This plan provides medical, surgical, preventive and chemical dependency services.

Medication Management: The ordering and monitoring of your medications. This does not include covering the cost of your medications.

Mental Health Organization (MHO): A plan that provides mental health services.


Residential Care Program: A facility providing room, board and mental health services. The program helps you function at home or school and in the community.


Service Area: The counties in Oregon we serve. Our area includes Baker, Clatsop, Columbia, Gilliam, Grant, Harney, Lake, Malheur, Morrow, Sherman, Tillamook, Umatilla, Union, Wallowa, and Wheeler counties. You must live in one of those counties to receive our services.


Skills Training: A program to help you function socially. It helps you manage your money. It also helps you eat right and teaches you how to cook.


Therapeutic Group Home: A care setting that helps you develop home skills.


Therapy: Care meeting the goals of your treatment plan.


Treatment Foster Care: A program that helps you develop skills allowing you to live alone.


Urgent Care: Services provided within the next two days. You may use these services when your needs cannot wait for more than two days.