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MHP Provider Documents

This page is utilized by BHS Provider Staff to obtain forms, manuals and reports for the electronic health record, Cerner Community Behavioral Health.

County of San Diego COVID-19 BHS Information
SOC and NACT Tools and Resources

COVID-19

CYF Memo: #18 - Utilization Management (UM) – Temporary Revision Due to COVID-19 (pdf)
Effective March 15, 2020 Until Further Notice 2020-04-01
HHSA Contractor Notice - Guidance for County Staff and Contractors Regarding Telehealth (pdf )
Issued 03/23/2020 2020-04-01
Notice # 1 - BHS Provider Notice - COVID-19 (pdf)
Issued 03/13/2020 2020-03-27
Notice #2 - BHS Provider Notice - COVID-19 - Guidance and Best Practices (pdf)
Issued 03/17/2020 2020-03-27
Notice #3 - BHS Provider Notice - COVID-19 - Quality Improvement Updates and Best Practices (pdf)
Issued 03/19/2020 2020-03-27
Notice #4 - BHS Provider Notice - COVID-19 - Financial Practices and Contract Management Updates (pdf)
Issued 03/20/2020 2020-03-27

NOABD

NOABD Webinar available online (new)

NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Modification_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Delivery_System_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Language_Assistance_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Payment_Denial_Notice_-_ENGLISH.docx
- 2018-08-07
NOABD_Timely_Access_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Timely_Access_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Denial_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Your_Rights_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Modification_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Denial_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Termination_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Modification_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Payment_Denial_Notice_-_ARABIC.docx
- 2018-08-07
NOABD_Modification_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Denial_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_VIETNAMESE.pdf
- 2018-08-07
NOABD_Your_Rights_Notice_-_FARSI.pdf
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Language_Assistance_Notice_-_ENGLISH.pdf
- 2018-08-07
NOABD_Your_Rights_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_SPANISH.pdf
- 2018-08-07
NOABD_Financial_Liability_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Delivery_System_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Termination_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Termination_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Termination_Notice_-_ENGLISH.doc
- 2018-08-07
NOABD_Termination_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Payment_Denial_Notice_-_VIETNAMESE.docx
- 2018-08-07
NOABD_Modification_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Modification_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Payment_Denial_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Financial_Liability_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Timely_Access_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_ENGLISH.pdf
- 2018-08-07
NOABD_Timely_Access_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Grievance_and_Appeal_Timely_Resolution_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Your_Rights_Notice_-_TAGALOG.pdf
- 2018-08-07
NOABD_Your_Rights_Notice_-_ARABIC.pdf
- 2018-08-07
NOABD_Denial_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Delivery_System_Notice_-_SPANISH.doc
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Payment_Denial_Notice_-_FARSI.docx
- 2018-08-07
NOABD_Authorization_Delay_Notice_-_VIETNAMESE.doc
- 2018-08-07
NOABD_Delivery_System_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Delivery_System_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Financial_Liability_Notice_-_TAGALOG.docx
- 2018-08-07
NOABD_Your_Rights_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Denial_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Financial_Liability_Notice_-_ARABIC.doc
- 2018-08-07
NOABD_Delivery_System_Notice_-_FARSI.doc
- 2018-08-07
NOABD_Termination_Notice_-_FARSI.doc
- 2018-08-07
NOABD Denial Notice- ENGLISH (docx)
2020-02-10
NOABD Log (xlsx)
2020-04-16
NOABD Table (pdf)
Revised 01/08/2020 2020-01-08
SanWITS NOABD
SanWITS NOABD

Beneficiary

Beneficiary Non-Discrimination Notice - ENGLISH (pdf)
2018-08-07
Beneficiary Materials MHP Order Form (docx)
2019-10-04
Full Guide Arabic 2019 (pdf)
Arabic 2019-07-10
Full Guide Farsi 2019 (pdf)
Farsi 2019-07-10
Quick Guide to MH Services - English (pdf)
2019-05-16
Quick Guide to MH Services - Spanish (pdf)
2019-05-16
Quick Guide to MH Services - Tagalog (pdf)
2019-05-16
Quick Guide to MH Services - Farsi (pdf)
2019-05-16
Quick Guide to MH Services - Vietnamese (pdf)
2019-05-16
Quick Guide to MH Services - Arabic (pdf)
2019-05-16
Full Guide Vietnamese 2019 (pdf)
MHP_Beneficiary_Handbook_Rv_5_01_2019_VIETNAMESE.pdf 2019-05-13
Full Guide Tagalog 2019 (pdf)
MHP_Beneficiary_Handbook_Rv_5_01_2019_TAGALOG.pdf 2019-05-13
Full Guide English 2019 (pdf)
MHP_Beneficiary_Handbook_1_24_2019.pdf 2019-02-01
Full Guide Spanish 2019 (pdf)
MHP-Beneficiary-Handbook-SPANISH 5 01 2019.pdf 2019-05-09
Limited_English_Proficiency_Poster_Vietnamese_07-10-18.pdf
- 2019-02-07
Limited_English_Proficiency_Poster_Tagalog_07-10-18_.pdf
- 2019-02-07
Limited_English_Proficiency_Poster_Spanish_07-10-18.pdf
- 2019-02-07
Limited_English_Proficiency_Poster_Farsi_07-10-18.pdf
- 2019-02-07
Limited_English_Proficiency_Poster_English_07-10-18.pdf
- 2019-02-07
Limited_English_Proficiency_Poster_Arabic_07-10-18.pdf
- 2019-02-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_ARABIC.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_FARSI.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_SPANISH.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_TAGALOG.docx
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_FARSI.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_SPANISH.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_TAGALOG.docx
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_VIETNAMESE.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_TAGALOG.docx
- 2018-08-07
Notice_of_Grievance_Resolution_-_SPANISH.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_FARSI.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_ENGLISH.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_ARABIC.doc
- 2018-08-07
Beneficiary Non-Discrimination Notice - ENGLISH (doc)
2018-08-07
NAR_Your_Rights_State_Hearing_-_VIETNAMESE.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_TAGALOG.docx
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_SPANISH.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_FARSI.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ENGLISH.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ARABIC.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_VIETNAMESE.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_ENGLISH.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Upheld_Notice_-_ARABIC.doc
- 2018-08-07
NAR_Adverse_Benefit_Determination_Overturned_Notice_-_ENGLISH.doc
- 2018-08-07
Notice_of_Grievance_Resolution_-_VIETNAMESE.doc
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_VIETNAMESE.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_TAGALOG.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_SPANISH.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_FARSI.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ENGLISH.pdf
- 2018-08-07
NAR_Your_Rights_State_Hearing_-_ARABIC.pdf
- 2018-08-07
Beneficiary_Non-Discrimination_Notice_-_VIETNAMESE.pdf
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_VIETNAMESE.doc
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_TAGALOG.pdf
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_TAGALOG.docx
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_SPANISH.pdf
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_SPANISH.doc
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_FARSI.pdf
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_FARSI.doc
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_ARABIC.pdf
2018-08-06
Beneficiary_Non-Discrimination_Notice_-_ARABIC.doc
2018-08-06
Beneficiary Problem Resolution Process (doc)
2018-06-28
Grievance-Appeal Brochure Farsi (pdf)
2018-02-28
Advance_Directive_Farsi.pdf
2018-02-28
NPP Acknowledgement - Farsi (pdf)
2018-02-13
Notice of Privacy Practices - Farsi (pdf)
2018-02-13
SD Grievance-Appeal POSTER Vietnamese (pdf)
2018-01-19
SD Grievance-Appeal POSTER Tagalog (pdf)
2018-01-19
SD Grievance-Appeal POSTER Spanish (pdf)
2018-01-19
SD Grievance-Appeal POSTER Farsi (pdf)
2018-01-19
SD Grievance-Appeal POSTER English (pdf)
2018-01-19
SD Grievance-Appeal POSTER English LARGE FONT (pdf)
2018-01-19
SD Grievance-Appeal POSTER Arabic (pdf)
2018-01-19
Grievance_and_Appeal_Form_-_JFS_Advocacy_12-20-17_FARSI.docx
2017-12-22
Grievance_and_Appeal_Form_-_CCHEA_Advocacy_12_20_17_FARSI.docx
2017-12-22
Grievance-Appeal Brochure Arabic (pdf)
2017-11-27
Grievance-Appeal Brochure English (pdf)
2017-11-27
Grievance-Appeal Brochure Farsi (pdf)
2017-11-27
Grievance-Appeal Brochure Spanish (pdf)
2017-11-27
Grievance-Appeal Brochure Tagalog (pdf)
2017-11-27
Grievance-Appeal Brochure Vietnamese (pdf)
2017-11-27
055__-_OPOH_-_Appendix_D_-_A.D.20_-TBS_Brochure_English_2015.pdf
2017-03-23
NoticeofPrivacyPractices_Vietnamese_12-16-14.pdf
2017-02-06
NoticeofPrivacyPractices_Tagalog_12-16-14.pdf
2017-02-06
NoticeofPrivacyPractices_Spanish_12-16-14.pdf
2017-02-06
NoticeofPrivacyPractices_English_12-16-14.pdf
2017-02-06
NoticeofPrivacyPractices_Arabic_12-16-14.pdf
2017-02-06
NPP_Acknowledgement_Vietnamese_2016.docx
2016-07-13
NPP_Acknowledgement_Tagalog_2016.docx
2016-07-13
NPP_Acknowledgement_Spanish_2016.docx
2016-07-13
NPP_Acknowledgement_English_2016.docx
2016-07-13
NPP_Acknowledgement_Arabic_2016.docx
2016-07-13
Grievance_and_Appeal_Form_--CCHEA_OP_Advocacy_1_15_16_TAG.docx
2016-04-01
Grievance_and_Appeal_Form_-_JFS_Advocacy_1_15_16.docx
2016-07-13
Grievance_and_Appeal_Form_-_JFS_Advocacy_1_15_16_ES.docx
2016-07-13
Grievance_and_Appeal_Form_-_JFS_Advocacy_1_15_16_AR.docx
2016-07-13
Grievance_and_Appeal_Form_-_JFS_Advocacy_1_15_16_Viet.docx
2016-07-13
Grievance_and_Appeal_Form_-_CCHEA_OP_Advocacy_1_15_16_AR.docx
2016-07-13
Grievance_and_Appeal_Form_-_CCHEA_OP_Advocacy_1_15_16_Viet.docx
2016-07-13
Grievance_and_Appeal_Form_-_CCHEA_OP_Advocacy_1_15_16_ES.docx
2016-07-13
Grievance_and_Appeal_Form_-_CCHEA_OP_Advocacy_1_15_16.docx
2016-07-13
Recovery_Brochure_Spanish_09-11rev.pdf
2016-07-13
Recovery_Brochure_English_8-5-13.pdf
2016-07-13
Physician_Notice_To_Patients_California_Regulation.pdf
2016-07-13
Advance_Directive_Vietnamese.pdf
2016-07-13
Advance_Directive_Tagalog.pdf
2016-07-13
Advance_Directive_Spanish.pdf
2015-10-09
Advance_Directive_English.pdf
2015-10-09
Advance_Directive_Arabic.pdf
2016-07-13

Communications

FAQ_-_Request_for_Servcies_Log_-_Access_Time_Report_-_9-30-14_.pdf
2016-07-15
QI_MIS_MEMO_2014_1_09_Notifications_in_Anasazi.pdf
2016-05-16
QM_Memo_-_90_Day_Lockout_Process_Update_11_06_13.pdf
2015-10-09
QM_MEMO_-_Documentation_Guidelines_when_EHR_Unavailable_9_04_14.docx
2015-10-09
QM_MEMO_-_New_Interactive_Add_On_Service_Code_785_9_22_14.docx
2015-10-09
QM_MEMO_-_Reaffirming_DHCS_Day_Treatment_Standards_08_26_14.docx
2015-10-09
QM_MEMO_DHP_4_14.pdf
2015-10-09
QI_MIS_MEMO_2015_11_20_Saving_Reports_to_a_SpreadsheetProcess_and Policy.pdf
2015-11-30
QM_MEMO_-_Day_Tx_Program_-_Updated_Standards.5.1.16.docx
2016-05-11
QI_MIS_MEMO_2016_05_09_CCBH_Outside_of_the_Office_Update.pdf
2016-05-11
QM_MEMO_-_ICD_Code_Updates_9_30_16.docx
2016-10-03
QI_MIS_MEMO_2016_10_31_CCBH_Demographic_Form_Table_Change.docx
2016-11-03
QI_MIS_MEMO_2016_12_01_CCBH_Client_Attachments.pdf
2018-05-25
QM_MEMO_- 42_CFR_Final_Rule_1-26-17.pdf
2017-02-02
QM_MEMO_-_Place_of_Service_Update_03_30_17.pdf
2017-03-31
QM_MEMO_-_Day_Treatment_Interim_Folder_03_29_17.pdf
2017-03-31
QM_MEMO_-_Allowed_Services_Prior_to_Client_Plan_Completion_-_DHCS_Guidelines_6_20_17.pdf
2017-06-21
QM_MEMO_-_New_Evidence_Based_Practice_Indicators_06_23_17.pdf
2017-06-27
QM_MEMO_-_Utilization_of_BHA_Adult_Walk_In_for_OP_Walk_In_Services_6_21_17.pdf
2017-06-27
QM_MEMO_-_Client_Plan_Redesign_6-20-17.pdf
2017-06-27
QM_MEMO_-_New_Auth_to_Use-Disclose_Multiple_Form_051513.pdf
2017-05-12
Intensive_Service_Request_ISR_CYF_Memo_04-1617.pdf
2017-06-30
QM MEMO_-_Specialty_Mental_Health_Service_Claiming_for_ES-HS_9_7_18.pdf
2018-10-08
3/19/20 BHS Provider Notice #3- COVID 1- Quality Improvement Updates and Best Practices (pdf)
2020-03-20
CSI Correction Guide (pdf)
Revised 12/16/2019 2019-12-30
CSI Requirement for MH Programs 08 27 12 (pdf)
2016-07-15
CYF MEMO - Revised CANS Sharing Confirmation 3.26.19 (pdf)
2019-04-09
CYF MEMO - Updated Ancillary SMHS Request Form (pdf)
Effective 1/1/2020 2020-01-10
CYF MEMO - Utilization Management Outpatient Cycle Expansion (pdf)
Issued 12/20/2019 2019-12-30
CYF MEMO – IHBS Prior Authorization 08/16/19 (pdf)
2019-08-20
CYF MEMO – Revised UM Request Form (pdf)
Issued 09/03/2019 2019-09-06
CYF Memo Prior Auth for Day Services (pdf)
Effective 1-1-2020 2020-01-10
CYF Memo – TBS Prior Authorization Process (pdf)
Issued 7/29/19 2019-08-14
Optum San Diego Website MH Provider Registration Instructions (pdf)
2019-11-04
QI - PIT MEMO - SOC Application (pdf)
2019-11-04
QI MIS MEMO CCBH Access to Services Journal (pdf)
2018-06-15
QIP Texting Presentation (pptx)
2020-01-21
QI_PIT_MEMO_2018 6-1-18 AOA Substance Use Tracking Reporting Changes (pdf)
2018-06-14
QM MEMO - CSI Diagnosis errors (pdf)
Issued 12/26/2019 2019-12-30
QM MEMO - Controlled Substance - CURES Mandate (pdf)
2018-06-08
QM MEMO - Medication Monitoring (pdf)
Issued 01/31/2020 2020-01-31
QM MEMO - NOABD Logs (pdf)
Issued 01/31/2020 2020-01-31
QM MEMO - New BHS 025 Forms (docx)
2019-04-24
QM MEMO - New Updated Discharge Form - 4.4.19 (pdf)
2019-04-12
QM MEMO - Patient_Advocacy Services for BHS - Record Requests 11 01 18 (pdf)
2018-10-31
QM MEMO - Privacy - Confidentiality Legislative Updates 10.23.18 (docx)
2018-10-24
QM MEMO - Prospective Risk Analysis (docx)
2019-01-09
QM MEMO - Specialty Mental Health Service Claiming for ES-HS (pdf)
2018-09-10
QM MEMO – AOA Outpatient Utilization Management 06 29 18 (pdf)
2018-07-13
QM MEMO – Billing for C-practitioners 07 02 18 (docx)
2018-07-13
QM MEMO – ICD-10 Updates 1.7.19 (docx)
2019-01-14
QM MEMO – PROSPECTIVE RISK ANALYSIS – 02.07.19 (docx)
2019-02-08
QM MEMO – PROSPECTIVE RISK ANALYSIS – 02.14.19 (doc)
2019-02-08
QM MEMO_-_New_Non-Bill_Other_Support_Service_Code_01_29_18.pdf
2018-11-29
QM Memo - CPT Coding Changes 2013 (pdf)
2016-07-15
QM Memo - DHCS Revised Telehealth Policies (docx)
Issued 12/06/2019 2019-12-09
QM Memo - EBP Indicator Removal for Homework & Child Family Team Meetings (docx)
Issued 02/06/2020 2020-02-07
QM Memo - Holder of Records 01 03 13 (pdf)
2016-07-15
QM Memo - LPCC Credential Under MHP 07 24 13 (doc)
2015-10-09
QM Memo - New Billing Indicators - Intrepreter and Language 06-08-17 (pdf)
2017-06-14

Forms

5150 Form (pdf)
2018-06-20
72 Hour Post Discharge Log (pdf)
2017-03-23
Access to Services Log (xlsx)
2018-06-20
BHS Serious Incident Report (doc)
2018-12-20
BHS Serious Incident Report of Findings (doc)
2018-12-20
BHS-025 Form A (docx)
Client Information - Revised 3/2019 2019-04-22
BHS-025 Form A and B Tip Sheet (docx)
Client Information - Revised 4/2019 2019-05-02
BHS-025 Form B (docx)
Client Information - Revised 3/2019 2019-04-22
Case Management Six Month Review Progress Note (pdf)
2017-03-23
Case Management UR Record (pdf)
2017-03-23
Case Management URC Minutes Form (pdf)
2017-03-23
DPC 203 Contractor (xlsx)
2018-09-21
DPC 203 Fillable (pdf)
2019-06-03
DPC 203 Mobile Devices (xls)
2019-06-03
DPC 203 Mobile Devices SUPPLEMENTAL 2017 (xls)
2018-06-20
DPC 203 Salvage and Disposal Flowcharts (pdf)
2019-06-03
Group Service Record (rtf)
2017-07-11
Individual Service Record (doc)
Revised 10/09/2019 2019-10-10
JV220(A) - Physician's Statement - Attachment (pdf)
2018-03-01
JV220(B) - Physican's Request to Continue Medication - Attachment (pdf)
2018-03-01
MAA Service Record (pdf)
2017-08-24
Med Mon McFloop Form (docx)
Revised 01/17/2020 2020-01-31
Med Monitoring Submission Form – Adult (xlsx)
Revised 01/17/2020 2020-01-31
Med Monitoring Submission Form – Children’s (xlsx)
Revised 01/17/2020 2020-01-31
Med Monitoring Tool AOA (docx)
Revised 01/17/2020 2020-01-31
Med Monitoring Tool CYF (docx)
Revised 01/17/2020 2020-01-31
Medi-Cal Administrative Activities (MAA) Procedures
2017-08-24
Medication Monitoring Submission Form – Children (xlsx)
2018-07-26
NVRA_Voter_Preference_Form_Farsi.pdf
2017-09-14
Request for Verification of Veterans Eligibility (pdf)
2017-03-23
SERIOUS INCIDENT ROOT CAUSE ANALYSIS WORKSHEET (doc)
Revised 07/31/2012 2020-01-29
START TCC and URC Record (pdf)
2017-03-23
START URC Minutes Form (pdf)
2017-03-23

Manuals

Request_for_Services_Access_Times_Log_Manual_7-1-16_FINAL.pdf
2016-05-23
CYF_BHS_Provider_Resources_Manual_-_January_2017.pdf
2017-03-20
Medi-Cal_Manual_Third_Edition_ICC_IHBS_TFC_Jan_2018.pdf
2018-01-19
5150_Training_Manual_-_March_2014.pdf
2015-10-09
Financial Eligibility and Billing Manual (pdf)
2018-09-24
Inpatient_Operations_Manual (pdf)
Revised 01/15/2020 2020-02-03
MHP Beneficiary Handbook (pdf)
2019-02-12
Outcome Measures Manual San Diego CSS Programs (pdf)
Updated 06/19/2019 2019-06-28
Rady_CAPS_Operations_Handbook_-_8-2-13.pdf
2016-07-13

OPOH

058_-_02_-_OPOH_-_Appendix_E_-_A.E.5_-_FINAL_Coordination_of_Care_Form_Spanish.pdf
2016-07-13
058_-_03_-_OPOH_-_Appendix_E_-_A.E.6_-_FINAL_Coordination_of_Care_Form_Tagalog.pdf
2016-07-13
058_-_04_-_OPOH_-_Appendix_E_-_A.E.7_-_FINAL_Coordination_of_Care_Form_Viet.pdf
2016-07-13
088_-_OPOH_-_Appendix_G_-_A.G.11_-_SERIOUS_INCIDENT_ROOT_CAUSE_ANALYSIS_WORKSHEET.pdf
2016-07-13
089_-_OPOH_-_Appendix_G_-_A.G.12_-_RCA_WORKSHEET_Sample_2.pdf
2016-07-13
092_-_OPOH_-_Appendix_G_-_A.G.15_-_Perpetual_Inventory_Medication_Log_-_Rev._2_29_06.pdf
2016-07-13
093_-_0_-_OPOH_-_Appendix_G_-_A.G.16_-_Medication_Disposal_Log_-__Rev._3_1_06.pdf
2016-07-13
093_-_2_-_OPOH_-_Appendix_G_-_A.G.18_-_NVRA_Voter_Preference_Form_-_Arabic.pdf
2016-07-13
093_-_3_-_OPOH_-_Appendix_G_-_A.G.19_-_NVRA_Voter_Preference_Form_-_English.pdf
2016-07-13
093_-_4_-_OPOH_-_Appendix_G_-_A.G.20_-_NVRA_Voter_Preference_Form_-_Spanish.pdf
2016-07-13
093_-_5_-_OPOH_-_Appendix_G_-_A.G.21_-_NVRA_Voter_Preference_Form_-_Tagalog.pdf
2016-07-13
093_-_6_-_OPOH_-_Appendix_G_-_A.G.22_-_NVRA_Voter_Preference_Form_-_Vietnamese.pdf
2016-07-13
033-1_-_OPOH_-_Appendix_C_-_A_C_7_-_Written_Translation_Service_Authorization_Form.pdf
2016-07-13
033-2_-_OPOH_-_Appendix_C_-_A_C_8_-_Service_Authorization_Request_Form.pdf
2016-07-13
093_-_1 -_OPOH_-_Appendix_G_-_A.G.17_-_New_Program_Orientation-07-22-16.pdf
2016-08-16
Appendix_C_-_A.C.10_-_Reestablishment_Recommendation_Form.doc
2016-11-29
030 - OPOH - Appendix C - A.C.2 - AMHS - Walk-in Clinics Hours Contacts (pdf)
2019-07-18
113 - OPOH - Appendix N - A.N.1 - MAA Procedures (pdf)
2016-07-13
OPOH - Organizational Providers Operation Handbook (pdf)
Revised 04/08/2020 2020-04-09
01 - Cover Sheet Org Provider Manual (pdf )
2018-09-20
02 - Table of Contents Org Prov Op Handbook (pdf)
Revised 04/08/2020 2020-04-09
03 - OPOH - Customer Service Mission (pdf)
Revised 04/08/2020 2020-04-09
031 - OPOH - Appendix C - A.C.3 - Transition Age Youth Referral Form (pdf)
Revised 04/15/2014 2016-07-13
032 - OPOH - Appendix C - A.C.4 - Transtion Age Youth Referral Plan 4-15-14 (pdf)
Revised 04/15/2014 2016-07-13
033 - OPOH - Appendix C- A.C.5 - Reestablishment Recommendation Form (pdf)
2016-07-13
04 - OPOH - Section A - Systems of Care (pdf)
Updated 10/23/2019 2019-11-07
05 - OPOH - Section B - Compliance Confidentiality (pdf )
Updated 07-09-2019 2019-07-18
056 - OPOH - Appendix E - A.E.1 - FINAL Coordination of Care Form - English (pdf)
2016-07-13
057 - OPOH - Appendix E - A.E.2 – HSD Plan Partner Card (pdf)
2020-02-20
058 - 00 - OPOH - Appendix E - A.E.3 - Plan Partner Identification for Pharmacies (pdf)
2016-07-13
058 - 01 - OPOH - Appendix E - A.E.4 - FINAL Coordination of Care Form - Arabic (pdf)
2016-07-13
06 - OPOH - Section C - Accessing Services (pdf)
Revised 03/25/2020 2020-04-09
07 - OPOH - Section D - Providing Specialty Mental Health Services (pdf)
Revised 04/02/2020 2020-04-09
08 - OPOH - Section E - Integration With Physical Healthcare (pdf)
2019-06-25
09 - OPOH - Section F - Beneficiary Rights, Grievance_and Appeals (pdf)
Revised 01/08/2020 2020-01-10
10 - OPOH - Section G - Quality Improvement (pdf)
Revised 02/04/2020 2020-02-13
102 - OPOH - Appendix J - A.J.1 - BHS Inventory Form 2010 (pdf)
2016-07-13
105 - OPOH - Appendix K - A.K.1 - Formal Complaint by Provider Form (pdf)
2016-07-13
106 - OPOH - Appendix K - A.K.2 - Formal Response To Complaint Form (pdf)
2016-07-13
107 - OPOH - Appendix K - A.K.3 - Formal Appeal by Provider Form (pdf)
2016-07-13
108 - OPOH - Appendix K - A.K.4 - Formal Appeal Response Form (pdf)
2016-07-13
109 - 01 - OPOH - Appendix L - A.L.1 - Monitoring Psychtropic Medications (pdf)
7-16-12 2016-07-13
11 - OPOH - Section H - Cultural Competency (pdf)
Updated 12/03/2019 2019-12-11
111 - OPOH - Appendix M - A.M.1 - License Waiver Form (pdf)
Revised 06/15/2010 2016-07-13
112 - OPOH - Appendix N - Data Requirements (pdf)
2016-07-13
114 - OPOH - Appendix N - A.N.2 Service Record (pdf)
2016-07-13
118 - OPOH - Appendix R - Quick Reference Guide (pdf)
2016-07-13
12 - OPOH - Section I Management Info System (pdf)
Revised 02/21/2020 2020-03-02
13 - OPOH - Section J - Provider Contracting (pdf)
Revised 02/25/2020 2020-03-02
14 - OPOH - Section K - Provider Issue Resolution (pdf)
Revised 02/19/2020 2020-03-02
15 - OPOH - Section L - Practice Guidelines (pdf)
Revised 02/19/2020 2020-03-02
16 - OPOH - Section M - Staff Qualifications (pdf)
Updated 09/04/2019 2019-09-10
17 - OPOH - Section N - Data Requirements (pdf)
Revised 02/21/2020 2020-03-02
18 - OPOH - Section O - Training (pdf)
Updated 10/23/2019 2019-11-07
19 - OPOH - Section P - Mental Health Services Act (pdf)
Updated 10/23/2019 2019-11-07
20 - OPOH - Section Q - Payment Schedule and Budget Guidelines for Cost Reimbursement Contract Only (pdf)
2019-06-06
21 - OPOH - Section R - Quick_Reference (pdf)
2019-05-22
Appendix A - A.A.3 - HOW Service Model Data Collection Flow (pdf)
Added 08/28/2019 2019-08-28
BHS Property Inventory Form (pdf)
2020-02-24
Capital Asset Request Form 253 (pdf)
2020-02-24
DPC 203 Transfer or Disposition of Minor Equipment Form Fillable (pdf)
2020-02-24
HSD Drug Carve Out - Plan Partner Card (pdf)
2020-02-20

References

EPSDT_TBS_Brochure_English.pdf
2016-07-15
EPSDT_TBS_Brochure_Spanish.pdf
2016-07-15
State_Plan_Amendment_SPA_12-025.pdf
2015-10-09
County_Webinar_ICD-10-CM_QandA_Final_9-11-15.docx
2016-07-15
ICD_10_and_DAS_Tip_Sheet_09.2015.docx
2016-07-15
Diagnosis_Practice_Guidelines_Rv_03_01_16.pdf
2016-03-15
Prof_License_Waiver_Requirements_DHCS.pdf
2016-10-07
Abbreviation List_-_BHS_Version_Final_11_30_16.docx
2016-11-30
New_Program_Orientation_-_QI_Checklist_Rev_12_15_16.pdf
2016-12-19
036_-_OPOH_-_Appendix_D_-_A.D.02_-_Medical_Necessity_Criteria_for_MHP__-_Rev_7-14-09_.pdf
2017-03-23
037_-_OPOH_-_Appendix_D_-_A.D.03_-_California_State_Penal_Institutions_List_.pdf
2017-03-23
QI_UPDATES_-_Annual_7_11_17 FINAL.pdf
2017-07-13
State_Health_Information_Guidance_-_December_2017.pdf
2017-12-18
Program_Provider_Numbers_List.pdf
2018-02-15
Travel_Time_Guidelines_Final_2-01-18.pdf
2018-02-15
FAQs from CPT Changes 2013 Webinar (pdf)
2016-07-15
Setting the Face Sheet to Display Instructions (doc)
2016-07-15
CCBH_-_CP_Folder_and_PN_TIP_SHEET-updated_6_16_17.pdf
2017-06-27
CCBH_-_Quick_Click_Guide_REVIEW_-_REVISE-updated_6_16_17.pdf
2017-06-27
CCBH_CP_Quick_Click_Guide-updated_6_16_17.pdf
2017-06-27
Client_Management_Payment_Report_V3.pdf
2016-07-15
CPT_Changes_2013_Presentation.pdf
2015-10-09
CPT_Codes_New_2013.pdf
2015-10-09
CPT_2013_Coding_Changes_FAQ.doc
2016-07-15
EM 101 - CPT Coding Changes - 2013 (pdf)
2015-10-09
PWB Report Template Instructions (pdf)
2016-05-16
Payment Appilication Claims Report Instructions (pdf)
2016-05-16
Service_Date_Verification_Report.pdf
2016-05-16
3rd Party Suspense Report Instructions (ppt)
2019-04-10
Appendix III – Service Code Approved Use Summaries (pdf)
2019-03-21
BILLING LOCKOUT SETTINGS AND NON-REIMBURSABLE / REIMBURSABLE ACTIVITIES (pdf)
2018-08-10
CCBH Report Uses for Program Integrity (pdf)
2019-10-07
CCBH Void Replace Form (xlsm)
Revised 11/08/2019 2019-11-11
CYF Brief Treatment Model (pdf)
Updated 6/28/2019 2019-07-01
Client Categories Maintenance (pdf)
2018-06-29
Clinical Standard for Assessments (doc)
2018-06-15
Clinical Standards For Client Plans (pdf)
Updated 6/28/2019 2019-07-01
Denial Report Instructions (ppt)
2019-09-16
EM 102 CPT Coding Changes - 2013 (pdf)
2015-10-09
ICD-10 Crosswalk version 2.3 (xlsx)
2019-03-21
ICD-10 Inpatient Included Diagnosis for SMHS 18-19 (pdf)
2019-01-14
ICD-10 Outpatient Included Diagnosis for SMHS 18-19 (pdf)
2019-01-14
MIS-25 Program Listing Report (xlsx)
Issued 02/10/2020 2020-02-11
MRR Tool FY 19-20 (xlsx)
2019-08-08
Progress Note Checklist Table (pdf)
Checklist 2020-03-10
QUALITY IMPROVEMENT KNOWLEDGE FORUM Presentation (pdf)
presented July 12, 2019 2019-07-18
Quality Improvement Annual Forum 2018 - Powerpoint (pptx)
07-25-2018 Presentation 2018-07-26
Reasons for Recoupment FY 2018-19 (pdf)
2019-01-22
SOC Application - QIP Presentation (pdf)
Presented 10/22/19 2019-10-23
Tip Sheet For Billable Services (docx)
2019-06-26
Trauma-Informed Care Code of Conduct (pdf)
2019-06-17
Treatment Team Documentation Standards (pdf)
2018-09-11

UCRM

Initial Screening PERT Form Fill (docx)
Revised 04/01/2020 2020-04-15
PSC- Youth Spanish 6 2018 Interactive (pdf)
2020-03-26
PSC- Parent Spanish 6 2018 Interactive (pdf)
2020-03-26
10 2018 PSC - Parent interactive (pdf)
Revised 3/2020 2020-03-26
10 2018 PSC - Youth Interactive (pdf)
Revised 3/2020 2020-03-26
PSC-Parent (Arabic)_6_2018_interactive (pdf)
2020-03-25
PSC-Parent (Farsi)_6_2018_interactive (pdf)
2020-03-25
PSC-Parent (TG)_6_2018_interactive (pdf)
2020-03-25
PSC-Youth (Arabic)_6_2018_interactive (pdf)
2020-03-25
PSC-Parent (VI)_6_2018_interactive (pdf)
2020-03-25
PSC-Youth (Farsi)_6_2018_interactive (pdf)
2020-03-25
PSC-Youth (TG)_6_2018_interactive (pdf)
2020-03-25
PSC-Youth (VI)_6_2018_interactive (pdf)
2020-03-25
Service Indicator Table Key (docx)
2020-03-18
NEVER BILLABLE PROGRESS NOTE FORM FILL (doc)
2020-03-18
OTHER PROGRESS NOTE FORM FILL (doc)
2020-03-18
DAY TREATMENT WEEKLY SUMMARY INSTRUCTIONS (docx)
2020-01-22
DAY TREATMENT WEEKLY SUMMARY (doc)
2020-01-22
PRIOR AUTHORIZATION DAY SERVICES REQUEST - EXPLANATION (pdf)
2020-01-10
ANCILLARY SMHS REQUEST - EXPLANATION (pdf)
2020-01-10
ANCILLARY SMHS REQUEST - FORM FILL (docx)
2020-01-10
PRIOR AUTHORIZATION DAY SERVICES REQUEST - FORM FILL (docx)
2020-01-10
UM Request Form (docx)
Revised 01/01/2020 2019-12-30
UM Request Explanation (pdf)
Revised 01/01/2020 2019-12-30
Psychiatric Assessment EHR Explanation (docx)
2019-12-12
BHA - CHILDREN JFS STAT FORM FILL (docx)
2019-10-16
TBS PRIOR AUTHORIZATION REQUEST AND REFERRAL FORM FILL (docx)
2019-08-14
TBS PRIOR AUTHORIZATION REQUEST AND REFERRAL – EXPLANATION (pdf)
2019-08-14
IHBS PRIOR AUTHORIZATION REQUEST FORM FILL (docx)
2019-08-20
IHBS PRIOR AUTHORIZATION REQUEST – EXPLANATION (pdf)
2019-08-20
MY SAFETY PLAN FORM FILL SPANISH (docx)
Revised 09/12/2019 2019-09-13
DEMOGRAPHIC FORM FILL (docx)
Revised 09/12/2019 2019-09-13
BHA – CHILDREN FORM FILL (docx)
2019-09-05
BHA - ADULT FORM FILL (doc)
Updated 08/09/2019 2019-08-09
BHA - EXPLANATION (docx)
2019-08-08
AUTHORIZATION TO USE OR DISCLOSE PHI FARSI (pdf)
Uploaded 07-23-2019 2019-07-23
MEDICATION PROGRESS NOTE SC27 (docx)
Uploaded 07-05-2019 2019-07-05
MEDICATION PROGRESS NOTE SC26 (docx)
Uploaded 07-05-2019 2019-07-05
MEDICATION PROGRESS NOTE SC25 (docx)
Uploaded 07-05-2019 2019-07-05
MEDICATION PROGRESS NOTE SC24 (docx)
Uploaded 07-05-2019 2019-07-05
DISCHARGE SUMMARY PAPER FORM INSTRUCTIONS (doc)
Uploaded 07-05-2019 2019-07-05
CLIENT PLAN FORM FILL (docx)
Uploaded 07-05-2019 2019-07-05
BHA - CHILDREN PAPER FORM INSTRUCTIONS (docx)
Uploaded 07-05-2019 2019-07-05
BHA - CHILDREN FORM FILL (docx)
Uploaded 07-05-2019 2019-07-05
BHA - ADULT PAPER FORM INSTRUCTIONS (docx)
Uploaded 07-05-2019 2019-07-05
MEDICATION PROGRESS NOTE SC28 (docx)
Uploaded 07-05-2019 2019-07-05
CLIENT PLAN SIGNATURE PAGE (docx)
2019-07-03
Locus Instrument Version 20 (pdf)
2019-06-28
DISCHARGE SUMMARY FORM FILL (docm)
2019-04-15
CANS SHARING CONFIRMATION FORM FILL (docx)
2019-04-15
SD – CANS Explanation Rv 3.11.19 (pdf)
2019-04-10
PSC – 35 Explanation Rv 3.4.19 (pdf)
2019-04-10
CANS Family Letter - Spanish (pdf)
2019-04-10
CANS Family Letter - Tagalog (pdf)
2019-04-10
CANS Family Letter - Arabic (pdf)
2019-04-10
CANS Family Letter - Vietnamese (pdf)
2019-04-10
CANS Family Letter - Farsi (pdf)
2019-04-10
CANS Sharing Confirmation page - Client Plan (pdf)
2019-04-09
CANS Sharing Confirmation - Explanation Sheet (pdf)
2019-04-09
CANS Family Letter (pdf)
2019-03-29
AOA OUTPATIENT UM EXPLANTION FORM (docx)
2019-02-08
AOA OUTPATIENT UM FORM FILL (docx)
2019-02-08
BHA – ESU FORM FILL (doc)
2019-02-08
BHA- START FORM FILL (doc)
2019-02-08
BHA – ADULT WALK IN FORM FILL (doc)
2019-02-08
HIGH RISK ASSESSMENT EXPLANATION (docx)
2019-02-08
PROSPECTIVE RISK ANALYSIS (PRA) FORM FILL (docx)
2019-02-08
PROSPECTIVE RISK ANALYSIS (PRA) EXPLANATION (docx)
2019-02-08
YOUTH TRANSITION SELF EVALUATION EXPLANATION (docx)
2019-01-29
CLIENT ASSIGNMENT FORM (doc)
2018-08-14
AOA PATIENT MEDICATION AGREEMENT – EXPLANATION (docx)
2018-07-26
INFORMED CONSENT PSYCHOTROPIC MEDICATION - SPANISH (docx)
2018-07-26
INFORMED CONSENT PSYCHOTROPIC MEDICATION - ENGLISH (docx)
2018-07-26
INFORMED CONSENT PSYCHOTROPIC MEDS EXPLANATION (docx)
2018-07-26
WRAPAROUND_PROGRESS_NOTE_FORM_FILL.doc
2018-07-24
MEDS_MANAGEMENT_LONG_NOTE_FORM_FILL.doc
2018-07-24
INDIVIDUAL_REHAB_PROGRESS_NOTE_FORM_FILL.doc
2018-07-24
INDIVIDUAL_PROGRESS_NOTE_OTHER_FORM_FILL.doc
2018-07-24
GROUP_REHAB_PROGRESS_NOTE_FORM_FILL.doc
2018-07-24
GROUP_PSYCHOTHERAPY_PROGRESS_NOTE_FORM_FILL.doc
2018-07-24
FAMILY_REHAB_PROGRESS_NOTE_FORM_FILL.doc
2018-07-24
FAMILY_PSYCHOTHERAPY_PROGRESS_NOTE_FORM_FILL.doc
2018-07-24
ESU_NURSING_NOTE_FORM_FILL.docx
2018-07-24
CASE_MANAGEMENT_PROGRESS_NOTE_FORM_FILL.doc
2018-07-24
AOA_PATIENT_MEDICATION_AGREEMENT_-_SPANISH.DOCX
2018-07-11
AOA Patient Medication Agreement English (pdf)
2018-06-08
CLIENT_PLAN_-_CHILDREN_EXPLANATION.docx
2018-02-13
CLIENT_PLAN_-_ADULT_EXPLANATION.docx
2018-02-13
PSYCHIATRIC_ASSESSMENT_FORMFILL.doc
2018-02-13
AIMS_FORMFILL.doc
2018-02-13
PRROGRESS_NOTES_EXPLANATION.docx
2018-02-13
WEEKLY_SUMMARY_EXPLANATION.docx
2018-02-13
TBS_TREATMENT_PLAN_EXPLANATION.docx
2018-02-13
SATS-R_ADULT_OUTCOME_EXPLANATION.docx
2018-02-13
MORS_ADULT_OUTCOME_EXPLANATION.docx
2018-02-13
LOCUS_ADULT_OUTCOMES_EXPLANATION.docx
2018-02-13
IMR_ADULT_OUTCOMES_EXPLANATION.docx
2018-02-13
CFARS_FORMFILL.doc
2018-02-13
CFARS_EXPLANATION.docx
2018-02-13
SAFETY_ALERTS_FORMFILL.doc
2018-02-13
INITIAL_SCREENING_FORMFILL.doc
2018-02-13
INITIAL_SCREENING_ESU_FORMFILL.doc
2018-02-13
DIAGNOSIS_FORM.docx
2018-02-13
BHA_-_TBS_EXPLANATION.docx
2018-02-13
BHA_-_ESU_EXPLANATION.docx
2018-02-13
DISCHARGE_SUMMARY_EXPLANATION.docx
2018-02-13
DIAGNOSIS_FORM_EXPLANATION.docx
2018-02-13
AUTHORIZATION_TO_USE_OR_DISCLOSE_PHI_EXPLANATION.docx
2018-02-09
TIERS_EMOTIONAL_BEHAVIORAL_PSYCHIATRIC.docx
2018-02-09
INITIAL_SCREENING_PERT_PAPER_FORM_INSTRUCTIONS.doc
2017-11-28
Explanation_for_Eligibility_form_10-25-17.pdf
2017-10-25
YOUTH_TRANSITION_SELF_EVALUATION_FORM_FILL_FARSI.docx
2017-09-14
YOUTH_TRANSITION_SELF_EVALUATION_FARSI.pdf
2017-09-14
MY_SAFETY_PLAN_FORM_FILL_FARSI.docx
2017-09-14
MY_SAFETY_PLAN_FARSI.pdf
2017-09-14
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATION_FORM_FILL_FARSI.docx
2017-09-14
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATION_FARSI.pdf
2017-09-14
CONSENT_FOR_SERVICES_FORM_FILL_FARSI.docx
2018-05-25
CONSENT_FOR_SERVICES_FARSI.pdf
2017-09-14
CONSENT_FOR_SERVICES_VIETNAMESE.docx
2017-08-07
CONSENT_FOR_SERVICES_TAGALOG.docx
2017-08-07
CONSENT_FOR_SERVICES_SPANISH.docx
2017-08-07
CONSENT_FOR_SERVICES_ARABIC.docx
2017-08-07
BHA_-_TBS_FORMFILL.doc
2017-06-14
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATION_ARABIC.docx
2017-04-04
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATION_TAGALOG.docx
2017-04-04
INFORMED_CONSENT_PSYCHOTROPIC_MEDICATION_VIETNAMESE.docx
2017-04-04
BHA_-_0-5_FORMFILL.docx
2017-03-29
BHA_-_DEC_FORM_FILL.docx
2017-03-28
TIERS_TRAUMA.docx
2018-05-25
TIERS_TABLE_EXPLANATION.docx
2018-05-25
TIERS_STRESS.docx
2018-05-25
TIERS_SPIRITUAL.docx
2018-05-25
TIERS_SOCIAL_FUNCTIONING.docx
2018-05-25
TIERS_POTENTIAL_FOR_HARM.docx
2018-05-25
TIERS_PHYSICAL_HEALTH_PROBLEMS.docx
2018-05-25
TIERS_NEUROLOGICAL_BRAIN_IMPAIRMENT.docx
2018-05-25
TIERS_NEGLECT_ABUSE.docx
2018-05-25
TIERS_MEANINGFUL_ROLE.docx
2018-05-25
TIERS_LEGAL.docx
2018-05-25
TIERS_LACK_OF_PHYSICAL_HEALTH_CARE.docx
2018-05-25
TIERS_INTIMATE_RELATIONSHIPS.docx
2018-05-25
TIERS_IDENTITY_ISSUES.docx
2018-05-25
TIERS_FINANCIAL.docx
2018-05-25
TIERS_FAMILY_STRESS.docx
2018-05-25
TIERS_EDUCATION.docx
2018-05-25
TIERS_BASIC_NEEDS.docx
2018-05-25
TIERS_ABUSE_ADDICTION.docx
2018-05-25
TBS_CLIENT_PLAN_SIGNATURE_PAGE.docx
2018-05-25
TBS_CLIENT_PLAN_FORM_FILL.docx
2018-05-25
STRENGTHS_TABLE.docx
2018-05-25
SATS-R_FORM_2.doc
2017-03-02
SAFETY_ALERTS_EXPLANATION.docx
2018-05-25
SAFETY_ALERT_PAPER_FORM_INSTRUCTIONS.doc
2017-03-02
TRANSITIONAL_YOUTH_REFERRAL_PLAN_FORM_FILL.doc
2018-05-25
TRANSITIONAL_YOUTH_REFERRAL_PLAN_EXPLANATION.docx
2018-05-25
TRANSITIONAL_AGE_YOUTH_REFERRAL_P&P.doc
2017-03-02
TIERS_VOCATIONAL_EMPLOYMENT.docx
2018-05-25
YOUTH_TRANSITION_SELF_EVALUATION_VIETNAMESE.doc
2018-05-25
YOUTH_TRANSITION_SELF_EVALUATION_SPANISH.doc
2018-05-25
YOUTH_TRANSITION_SELF_EVALUATION_ENGLISH.doc
2018-05-25
VITALS_FORMFILL.doc
2017-03-02
REQUEST_FOR_ACCESS_COPY_OF_PHI.doc
2017-02-17
RELEASE_OF_INFORMATION_CHILD_04-24A-P.dot
2017-02-17
PSYCHIATRIC_ASSESSMENT_PAPER_FORM_INSTRUCTIONS.doc
2017-02-17
MY_SAFETY_PLAN_FORM_FILL_TAGALOG.docx
2018-01-19
MY_SAFETY_PLAN_FORM_FILL_ENGLISH.docx
2018-01-19
MY_SAFETY_PLAN_FORM_FILL_ARABIC.docx
2018-01-19
MY_SAFETY_PLAN_EXPLANATION.docx
2018-06-21
MORS_ADULT_OUTCOME_MEASURE.docx
2018-05-25
MEDICAL_CONDITION_REVIEW_FORM_EHR.docx
2018-05-25
MEDICAL_CONDITION_REVIEW_EXPLANATION.docx
2018-05-25
MY_SAFETY_PLAN_FORM_FILL_VIETNAMESE.docx
2018-01-19
IMR_CLINICIAN_VERSION_072910.pdf
2018-05-25
HIGH_RISK_INDEX_FORM_FILL.docx
2018-05-25
HIGH_RISK_ASSESSMENT_FORM_FILL.docx
2018-05-25
ECBI_EXPLANATION.docx
2018-05-25
INITIAL_SCREENING_PAPER_FORM_INSTRUCTIONS.doc
2017-02-17
INITIAL_SCREENING_EXPLANATION.docx
2018-05-25
INITIAL_SCREENING_ESU_PAPER_FORM_INSTRUCTIONS.doc
2017-02-17
DEMOGRAPHIC_FORM_EXPLANTION.docx
2018-05-25
DAY_TREATMENT_CLIENT_PLAN.doc
2017-02-17
DAY_PROGRAM_REQUEST_SMHS.doc
2017-02-17
COORDINATION_OF_CARE_FORM_EXPLANATION.docx
2018-05-25
COORDINATION_OF_CARE_FORM.docx
2018-05-25
CONSENT_FOR_SERVICES_EXPLANATION.docx
2018-05-25
CONSENT_FOR_SERVICES.docx
2018-05-25
CLIENT_INFORMATION_FACE_SHEET_EXPLANATION.docx
2018-05-25
CAMS_YOUTH.pdf
2017-02-17
CAMS_PARENT.pdf
2017-02-17
CAMS_EXPLANATION.docx
2018-05-25
BHA_-_TBS_PAPER_FORM_INSTRUCTIONS.doc
2017-02-17
BHA_-_ESU_PAPER_FORM_INSTRUCTIONS.doc
2017-02-17
Authorization to Use or Disclose PHI - VIETNAMESE (pdf)
Vietnamese 2017-02-17
Authorization to Use or Disclose PHI - TAGALOG (pdf)
Tagalog 2017-02-17
Authorization to Use or Disclose PHI - SPANISH (pdf)
Spanish 2017-02-17
Authorization to Use or Disclose PHI - ENGLISH (pdf)
English 2017-02-17
Authorization to Use or Disclose PHI - CHILD (dot)
2017-02-17
Authorization to Use of Disclose PHI - ARABIC (pdf)
Arabic 2017-02-17
AIMS_EXPLANATION.docx
2018-05-25
ADVANCE_DIRECTIVE_ADVISEMENT_EXPLANATION.docx
2018-05-25
ADVANCE_DIRECTIVE_ADVISEMENT.doc
2018-05-25
ACKNOWLEDGEMENT_NPP.docx
2018-05-25

UTTM

QM...Up to the Minute - April 2020 (pdf)
2020 2020-04-09
QM...Up to the Minute - March 2020 (pdf)
2020 2020-03-31
QM...Up to the Minute - February 2020 (pdf)
2020 2020-02-13
QM...Up to the Minute - January 2020 (pdf)
2020 2020-02-13
QM...Up to the Minute - December 2019 (pdf)
2019 2020-02-13
QM...Up to the Minute - October 2019 (pdf)
2019 2019-10-10
QM...Up to the Minute - November 2019 (pdf)
2019 2019-11-20
QM...Up to the Minute - September 2019 (pdf)
2019 2019-09-24
QI...Up to the Minute - FY 2018-2019 (pdf)
2018-2019 2019-09-24
QM...Up to the Minute - July 2019 (pdf)
2019 2019-07-23
QI...Up to the Minute - August 2019 (pdf)
2019 2019-08-14
QI...Up to the Minute - June 2019 (pdf)
2019 2019-07-11
QI...Up to the Minute - May 2019 (pdf)
2019 2019-05-10
QI...Up to the Minute - April 2019 (pdf)
2019 2019-04-12
QI...Up to the Minute - March 2019 (pdf)
2019 2019-03-14
QI...Up to the Minute - February 2019 (pdf)
2019 2019-02-15
QI...Up to the Minute - January 2019 (pdf)
2019 2019-01-10

Training

Progress Notes Orientation and Practice Exercises available online (new)
Client Plans and Progress Notes Orientation and Practice Exercises available online (new)
CCBH Login Process Tutorial available online (new)
Progress Notes and Service Codes Webinar available online (new)
NOABD Webinar available online
Service Indicators Webinar available online
BHA Webinar available online
Client Plan Webinar available online
Progress Notes v3 Video Tutorials available online
Billing Correction Tutorials available online
Access to Services Journal Video Tutorial available online.




PWB

Explanation_for_Eligibility_form-10-25-17.pdf
2017-11-07
Eligibility-for-PWB-and-Enhanced-Services-Form-Fill-09.20.2017.docx
2017-11-07
Child and Family Team (CFT) Meeting Note Form Fill (06-28-18) (docx)
2018-07-02
Child and Family Team (CFT) Meeting Note Explanation (pdf)
2018-06-21
Intensive Care Coordination (ICC) (pdf)
2018-06-21
Intensive Care Coordination (ICC) Note Explanation (pdf)
2018-10-30
Progress Report to Child Welfare Services Explanation (10-4-18) (pdf)
2018-10-05
Progress Report to Child Welfare Services Form Fill (10-4-18) (docx)
2018-10-05

BHS Reports

AOA Annual Medication Monitoring Report FY 16-17 (pdf)
2017-11-30
AOA Annual Medication Monitoring Report Q2 FY17-18 (pdf)
2018-02-12
BHS Dashboard October 2017 (pdf)
2017-11-07
BHSDatabook_FY16-17_Final.pdf
2018-02-09
BHSDatabook_FY2014-15.pdf
2016-05-25
CYF Annual Medication Monitoring Report FY 16-17 (pdf)
2017-11-30
CYF Medication Monitoring Report Q2 FY17-18 (pdf)
2018-02-12
FY_2016-17_BHS_Factsheet_Combined_FINAL.pdf
2018-02-09
Medical Record Reviews FY 2017-18 Trending Questions Summary AOA and CYF Programs Q3 FY 2017-18 (pdf)
2018-05-01
Mental Health Performance Dashboard Combined - FY2017-18 (pdf)
2018-01-22
QM - MRR - Trending Questions Report - Q1 FY 18-19 (pdf)
2018-10-05
QM - MRR - Trending Questions Report - Q1 FY 19-20 (pdf)
2019-10-25
QM - MRR - Trending Questions Report - Q2 FY 18-19 (pdf)
2019-01-24
QM - MRR - Trending Questions Report - Q3 FY 18-19 (pdf)
2019-05-01

STRTP

CYF MEMO – STRTP Release of Forms 08/16/19 (pdf)
2019-08-20
STRTP ADMISSION STATEMENT FORM FILL (docx)
2019-09-05
STRTP ADMISSION STATEMENT – EXPLANATION (pdf)
2019-09-05
STRTP DISCHARGE SUMMARY - EXPLANATION (pdf)
Uploaded 07-05-2019 2019-07-05
STRTP DISCHARGE SUMMARY FORM FILL (docm)
Uploaded 07-05-2019 2019-07-05
STRTP Hybrid Matrix (docx)
2020-01-22
STRTP MEDICATION NOT PRESCRIBED PROGRESS NOTE SC11 (docx)
Uploaded 07-05-2019 2019-07-05
STRTP Medication Flow Chart (pdf)
Uploaded 07-05-2019 2019-07-05
STRTP TRANSITION DETERMINATION PLAN FORM FILL (docm)
Uploaded 07-05-2019 2019-07-05
STRTP TRANSITION DETERMINATION PLAN – EXPLANATION (pdf)
Uploaded 07-05-2019 2019-07-05