Please Read: Provider Services Communications during the COVID-19 Crisis
TERM is an acronym for Treatment and Evaluation Resources Management, a mental health program developed under the direction of the County of San Diego Board of Supervisors and operated by Optum through a contract with County of San Diego HHSA Behavioral Health Services. The mission of the TERM program is to improve the quality and effectiveness of mental health services provided to clients served by the Dependency and Delinquency systems. Optum is responsible for contracting providers to the TERM network who have competence in evaluating and treating clients referred for child maltreatment or delinquency concerns. Optum also provides quality oversight of treatment plans and evaluation reports prepared for these clients.
This page is utilized by providers on the TERM specialty network to obtain documents and related materials needed for their work with Child Welfare Services and Probation clients.
Clinical Specialty Additions
Specialty Addition Application
Manuals
TERM Provider Handbook
TERM Provider Handbook Appendices
- 1. Court Testimony in the Juvenile Court System (pdf)
- 2. CWS Form 04-176A Therapy Referral Form (pdf)
- 3. CWS Form 04-178 Request for TERM Appointed Evaluator (pdf)
- 4. CWS Treatment Plan Documentation Resources (pdf)
- 5. CWS Form 04-176/04-177 – Parent (docx)
- 6. CWS Form 04-176/04-177 – Youth (docx)
- 7. Delinquency System Legal Process (pdf)
- 8. Dependency System Legal Process (pdf)
- 9. Documentation Requirements (pdf)
- 10. Legal Issues Related to Therapy and Evaluations for CWS Cases
- 11. Probation Psychiatric Evaluation Referral Form (pdf)
- 12. Probation Psychological Evaluation Referral Form (pdf)
- 13. Psychological Evaluation Procedures (pdf)
- 14. San Diego Juvenile Court Procedure to Obtain Authorization to Use or Disclose Protected Mental Health Information for Evaluations of Minor in Custody (pdf)
- 15. Serious Incident Report (doc)
- 16. Specialized Optum TERM Panel Evaluations (pdf)
- 17. Superior Court of the State of California Order (pdf)
- 18. The Format and Required Elements of a Probation Psychiatric Evaluation (pdf)
- 19 . The Format and Required Elements of a CWS Psychological Evaluation (pdf)
- 20. The Format and Required Elements of a Juvenile Mental Competency Evaluation (pdf)
- 21. The Format and Required Elements of a Probation Psychological Evaluation (pdf)
- 22. The Format and Required Elements of a Juvenile Threat Assessment (pdf)
CWS Treatment
CWS Treatment Plan Forms
CWS Referral Form
Resources
CWS Temporary Change of Authorization
Medi-Cal Funded CWS Therapy
CWS Treatment Plan Documentation
Request for Authorization of Additional Units of CFT Meeting Form Through CWS Funds
IPV Victim Group Treatment
TERM IPV Victim Group Treatment Standards
IPV Victim Progress Reporting Forms
Resources
CSA-NOP/NPP Treatment
CSA-NPP Treatment Standards
- 1. CSA-NPP Treatment Standards (pdf)
- 2. Sexual Abuse Protection: Parent Treatment for Non-Offending/Non-Protecting Parents Mental Status/Psychiatric Symptoms (pdf)
- 3. Assessment Tools (pdf)
- 4. Scoring Sheet for Required Screening Tools (pdf)
- 5. Safety Plan Guidelines (pdf)
- 6. On-Site Group Monitoring Tool (pdf)
CSA-NOP/NPP Progress Reporting Forms
CWS/Probation Evaluations
Format and Required Elements
- 1. Format and Required Elements of a CWS Psychological Evaluation (pdf)
- 2. Format and Required Elements of a Probation Psychological Evaluation (pdf)
- 3. The Format and Required Elements of a Probation Psychiatric Evaluation (pdf)
- 4. Format and Required Elements of a Juvenile Mental Competency Evaluation (pdf)
- 5. The Format and Required Elements of a Juvenile Threat Assessment (pdf)
CWS Evaluation Referral Form
- 1. Youth Evaluation Referral Questions – Emotional Damage (pdf)
- 2. Youth Evaluation Referral Questions – Adoption Evaluation (pdf)
- 3. Youth Evaluation Referral Questions – Diagnostic Clarification and Treatment Recommendations (pdf)
- 4. Parent Evaluation Referral Questions – FC 7827 (pdf)
- 5. Parent Evaluation Referral Questions – Prospective Adoptive Parent (pdf)
- 6. Parent Evaluation Referral Questions – Diagnostic Clarification and Treatment Recommendations (pdf)
Probation Evaluation Referral Form
Resources
Medi-Cal Funded CWS Evaluations
Request to Modify CPT Code Distribution for CWS Funded Evaluations
CANS/PSC
- CANS User Guide (pdf)
- Electronic CANS Form (pdf)
- CANS and PSC Instructions and Process Provider Correspondence (pdf)
- Electronic PSC - Parent Form (pdf)
- Electronic CANS Form – Early Childhood Version (pdf)
- Electronic CANS/PSC Resources & CWS Treatment Plan Documentation Update (pdf)
- Electronic PSC - Parent Form - Spanish (pdf)
- Electronic PSC - Youth Form (pdf)
- Electronic PSC - Youth Form - Spanish (pdf)
- CANS-PSC Completion Tip Sheet with link to Tools (pdf)
Newsletters
Contact Lists
TERM Updates
Grievances
- TERM_Grievance_Procedures_and_Complaint_Form_Arabic.pdf
- TERM_Grievance_Procedures_and_Complaint_Form_Spanish.pdf
- TERM_Grievance_Procedures_and_Complaint_Form_Vietnamese.pdf
- TERM_Grievance_Procedures_and_Complaint_Form_Tagolog.pdf
- TERM_Grievance_Procedures_and_Complaint_Form_English.pdf
- TERM Complaint Form for Professional Partners (pdf)
- TERM Partner Complaint Contacts (pdf)
COVID-19
Provider Services Info
Change of Practice Forms
Telehealth Attestation/Standards
Home Office Standards
Claims
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AMFT/ACSW/APCC Intern CWS Billing Codes (pdf)
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Revised 10/01/2022 | 2022-10-13 |
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LMFT/LCSW/LPCC CWS Billing Codes (pdf)
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Revised 10/01/2022 | 2022-10-13 |
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LMFT/LCSW/LPCC Medi-Cal Billing Codes (pdf)
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Revised 10/01/2022 | 2022-10-13 |
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MD/DO CWS Billing Codes (pdf)
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Revised 10/01/2022 | 2022-10-13 |
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PhD/PsyD CWS Billing Codes (pdf)
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Revised 10/01/2022 | 2022-10-13 |
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PhD/PsyD Intern CWS Billing Codes (pdf)
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Revised 10/01/2022 | 2022-10-13 |
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PhD/PsyD Medi-Cal Billing Codes (pdf)
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Revised 10/01/2022 | 2022-10-13 |