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NSA means Needs Special Assistance and is the identification for individuals who need special assistance due to a mental disability.

GR 41-101.2 – Identifying NSA

How do individuals become identified as NSA? Eligibility staff must refer any individual who appears to be mentally disabled to either Department of Mental Health (DMH) or Adult Protective Services (APS) staff for a mental health evaluation. If it is determined that the individual is mentally disabled, the case is identified as NSA. Refer to GR 41-104.2 for details on the referral process.

GR 41-101.3 –

Responsible Persons

Who is responsible for identifying individuals who appear to be NSA?

All public contact staff are responsible for identifying individuals who appear to be NSA as quickly as possible.

Security Officers, Receptionists, Information Workers, Screeners and Workers are to be on the alert to identify potentially NSA individuals.

GR 41-101.4 –

Department of Mental Health (DMH)

Is there training to help identify an individual as potentially NSA?

Yes, DMH professional staff provide training for all GR public contact staff on an ongoing basis. This training provides guidelines for identifying

individuals who may be mentally disabled for the purpose of referring them for a mental health evaluation, as well as to provide them expedited assistance throughout the GR process.

GR 41-102 – Identifying Mental Disabilities GR 41-102.1 – Observation

What are some things to look for in identifying individuals that may be NSA?

Following are guidelines to help identify individuals that may be NSA.

Some observable indicators are:

• appears very confused, frustrated or disturbed, • dresses inappropriately for the weather or

strangely attired;

• appears to be talking to themselves or making bizarre statements;

• displays inappropriate moods, such as crying uncontrollably;

• provides inappropriate answers to questions; • appears physically agitated or cannot sit still; • is very anxious or very depressed;

• is guarded or suspicious; • exhibits signs of cuts or burns; • has extremely poor hygiene;

• exhibits a hostile demeanor without cause or provocation; or

• appears to hear or see something that is not there.

GR 41-102.2 –

Informational Indicators

Are there any other indicators for identifying potential NSA individuals?

In addition to the observable characteristics, an individual may provide information during the course of a conversation with staff that indicates some mental disability, such as:

• Has taken or is taking psychiatric medication, such as Prozac, Seroquel, Paxil, Abilify, Lexapro, Geodon, etc.

• Has been hospitalized in the past 12 months in a psychiatric facility or other facility for psychiatric treatment.

committing suicide.

• Danger to or has a history of hurting self (e.g., signs of cuts or burns), or other people, or destroying property.

• Has undergone mental health treatment in last five years.

GR 41-103 – NSA Case Identification

Is there a form to help EWs decide whether a participant should be referred for a mental health assessment with Department of Mental Health (DMH) staff?

Yes, the ABP 4029, Mental Health Screening Form, leads the EW through a series of questions and assigns a point value for each question.

Participants who score seven or more are referred for an assessment by DMH staff.

• The EW asks the questions on the form and records the participant’s answer by entering a zero for “no” or the point value using the number (1, 3, 4, or 7 points) indicated by the “yes.” Then the total number of points is entered on line 11. • A score of seven or more triggers a referral to

DMH. Remember to attach this form to the PA 2012.

• Scores less than seven points are generally not referred to DMH.

• However, a participant who requests a referral can be referred, even if s/he scores less than seven points.

The EW may also refer participants who score less than seven points due to observable characteristics or another reason. The reason for the referral is written on the lines provided just below line 11 on the form.

GR 41-103.1 – Case Folder

How is a case folder identified for NSA individuals?

To ensure that mentally disabled individuals are easily recognized in order to receive the special assistance they require, the following measures are taken IMMEDIATELY upon identification as

• The active case segments of the case record are kept in a blue folder.

• A blue/white label is placed on the front of the blue folder with the mentally disabled individual’s name and the letters “NSA”.

• The top front of forms processed by public contact staff are annotated with NSA. GR 41-103.2 –

Identification on LEADER

How are NSA individuals identified on LEADER? NSA individuals are identified on LEADER with the employability status of NSA. The employability status is changed as soon as the determination is made that the individual is NSA.

If it is later determined that the individual is not NSA, the employability status is changed to the appropriate code and any needed case action is taken.

Refer to NSA for LEADER procedures. GR 41-103.3 – Needs

Help Reading and Writing

What needs to be done when an individual needs help reading and writing?

If an individual does not appear to be mentally disabled, but needs help in completing forms because they have difficulty in reading and writing: • The individual is assisted in reading and

completing the forms.

• These individuals are processed through normal procedures without priority handling.

• The front of the Documentation/Activity folder is annotated “Needs Help Reading and Writing” (color-coded folders are not used for these cases).

• The front of forms are annotate in red “Needs Help Reading and Writing.”

GR 41-103.4 – Use of