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SMI Designation Frequently Asked Questions

Mental Health

What is a “SMI” (Serious Mental Illness) designation?

Serious Mental Illness, or “SMI,” is a designation used in Arizona to identify people ages 18 and older who need extra support because of their mental illness. A designation is not a diagnosis for treatment.

If my doctor says I have a serious mental illness, will I automatically be designated SMI?

No. The SMI designation is specifically designed for people who have additional difficulty in daily activities because of their mental illness. People who have been designated SMI are in need of long-term services to be able to live in their community.

How do I get designated SMI?

You can ask for an SMI designation assessment from a healthcare provider, or you can be referred for an SMI designation assessment. A SMI designation assessment is a meeting with a health professional to figure out if you should have the SMI designation.

Who do I contact to set up an SMI assessment?

A case manager is the first person to contact concerning an SMI designation assessment. If you do not have a case manager or do not know who your case manager is, please contact member services for the AHCCCS Complete Care Regional Behavioral Health Authority (ACC-RBHA) that represents your area:

What do I need to qualify for the SMI designation?

The SMI assessment must show 2 things for the person to get the SMI designation:

  1. a qualifying diagnosis, AND
  2. a functional impairment because of the qualifying diagnosis.

What is a qualifying diagnosis for the SMI designation?

A qualifying diagnosis is a mental health disorder that makes someone eligible for an SMI designation. The following types of mental illnesses qualify for SMI designation:

  • Psychotic Disorders, Bi-Polar Disorders, or Obsessive-Compulsive Disorder
  • Depressive Disorders, Other Mood Disorders, Anxiety Disorders
  • Post-Traumatic Stress Disorder, Dissociative Disorder, or Personality Disorders

What is a functional impairment for the SMI designation?

A functional impairment means that a person has difficulty in at least one of the following areas as a result of their qualifying diagnosis:

  • living alone or with their family, without supervision;
  • risk of seriously harming self or harming others;
  • has a hard time in school or work; or
  • could get worse because of something else, like other health problems or substance use

Do I need an SMI designation to be eligible for health care or disability benefits?

No. You don’t need an SMI designation to be eligible for any of the following:

  • Vocational Rehabilitation (VR) Services
  • AHCCCS, including specific services like case management and supportive housing
  • Social Security Disability Insurance (SSDI) benefits or Social Security Income (SSI)

**Eligibility for these services is determined based on other criteria**

What will an SMI designation do for me?

People designated SMI may have access to:

Mental health services (even if you are not eligible for AHCCCS) including:

  • medication
  • medication management
  • crisis services, and
  • additional services based on need. These may include peer support, case management, and limited transportation services.

Help from a Human Rights Advocate through the Office of Human Rights (OHR), if you are identified as needing extra help. Human Rights Advocates can help you understand and protect your rights. You can reach OHR at 1-800-421-2124 or

How long will an SMI Designation last?

If you have received an SMI designation based on the fact that you were a danger to yourself or others, the decision may be reviewed in as soon as 3 months. Otherwise, SMI designations generally last until you request to have it removed.

How long will it take to get the results of my SMI determination?

You may have the results from the SMI determination within as little as 3 business days, but may be asked to agree to receive results within 20 days in order for records to be obtained and reviewed.

How will I know if I have been denied an SMI designation?

You will receive a letter called a “notice of action” or “notice of decision” from the AHCCCS designee authorized to make SMI determinations that says you are not eligible for the SMI designation and a reason why.

Can I appeal an SMI designation denial?

Yes. You may appeal the decision with the ACC-RBHA directly.

  • First, you must contact the ACC-RBHA in your area to file your appeal.
  • If your appeal is denied, you may file a complaint with your ACC-RBHA.

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