TERM Providers

This page is utilized by TERM providers to obtain documents and related materials needed for continued work with Child Welfare Services and Probation clients.

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Applications

New Provider Probation Only Application 01.24.18.docx
2018-05-10
Instructions and FAQs Credentailing and Contracting (docx)
2017-12-13
Medi-Cal and TERM Application (docx)
2018-01-24
New Provider TERM Only Application (docx)
2018-01-24
Optum TERM Intern Evaluator Application (doc)
2018-02-13
Optum TERM Standards for use of Evaluator Interns (doc)
2018-02-13
Optum TERM Standards for use of Therapy Interns (doc)
2017-12-13
Optum TERM Therapy Intern Application (docx)
2018-02-13
Paneled Medi-Cal Provider-TERM Application (docx)
2018-01-24
TERM Provider Specialty Addition Application (docx)
2018-01-24
W9 - Blank (pdf)
Request for Taxpayer Identification Number and Certification 2017-11-02

Communications

Vol1. 1 - Provider Newsletter.pdf
2018-05-10
TRES III Provider Tip Sheet.pdf
2018-05-10
TERM Newsletter 17 - Summer Quarter 7-30-2013.pdf
2018-05-10
TERM Newsletter 16 - Spring Quarter 2013.pdf
2018-05-10
TERM Newsletter 15 - Winter Quarter 2013.pdf
2018-05-10
TERM Newsletter 14 - Fall Quarter 2012.pdf
2018-05-10
TERM Newsletter 13 - Summer 2012.pdf
2018-05-10
TERM Newsletter 12 - Spring 2012.pdf
2018-05-10
TERM Newsletter 11 - Winter 2012.pdf
2018-05-10
TERM Newsletter 10 - Fall 2011.pdf
2018-05-10
TERM Newsletter 09 - July 2011.pdf
2018-05-10
TERM Newsletter 08 - March 2011.pdf
2018-05-10
TERM Newsletter 07 - January 2011.pdf
2018-05-10
TERM Newsletter 06 - October 2010.pdf
2018-05-10
TERM Newsletter 05 - June 2010.pdf
2018-05-10
Recovery and Resiliency Toolkit.pdf
2018-05-10
OPTUMIST Newsletter Summer 2015.pdf
2018-05-10
OPTUMIST Newsletter Spring 2015.pdf
2018-05-10
Important Update on Child Sexual Abuse Referrals.pdf
2018-05-10
Important TERM Historical Document-Original CAO Reponse to Board of Supervisors on Development of TERM Program.pdf
Image 2018-05-10
Clarification of Authorization for Medi-Cal Funded Psychological Evaluation.pdf
2018-05-10
Child Welfare Services Billing Codes.pdf
2018-05-10
Change in CWS Process of Authorizing Treatment or Release of Protected Health Information 2 5 14.pdf
2018-05-10
2013 APA Specialty Guidelines for Forensic Psychology.pdf
2013 APA Guidelines for Psychological Evaluations in Child Protection Matters.pdf
TERM Phone Line.doc
2015-10-09
Standards for use of Therapy Interns.doc
2015-10-09
Evaluator Interns Standards.doc
2015-10-09
Important Updates to Optum TERM Provider Handbook email 113015.pdf
2015-11-30
OPTUMIST Newsletter Fall 2015.pdf
2018-05-10
OPTUMIST Newsletter Winter 2016.pdf
2018-05-10
Optum TERM Expanded to Include Oversight of Child Sexual Abuse Non-Offending Non-Protecting Parent Treatment 2 1 16.pdf
2018-05-10
OPTUMIST Newsletter Spring 2016.pdf
2018-05-10
OPTUMIST Newsletter Summer 2016.pdf
2016-08-03
OPTUMIST Newsletter Winter 2017.pdf
2018-05-10
DEMOGRAPHIC FORMS
2016-11-02
Enhancing Clinical Practice 5-31-17.pdf
2017-05-09
May TERM Training Flyer (pdf)
2018-04-06
Medi-Cal CWS Auth Process FAQ 10 28 16.pdf
2016-10-28
Microsoft Outlook - Memo Style
2015-12-29
Microsoft Word - 1500 Claim Form Changes
2015-10-26
Microsoft Word - December 2009 TERM Newsletter.doc
2015-10-09
Microsoft Word - Document1
2015-10-26
Microsoft Word - ICD 10 claim insert and email blast
2015-10-09
Microsoft Word - June 2009 TERM Newsletter.doc
2015-10-09
Microsoft Word - March 2010 TERM Newsletter.doc
2015-10-09
Microsoft Word - November 2009 TERM Newsletter.doc
2015-10-09
Microsoft Word - Optum Letterhead PO Box
2015-10-09
Microsoft Word - TERM Network Closed
2016-03-16
Microsoft Word - URGENT Information.docx
2016-07-06
OPTUMIST Newsletter Spring 2017 (pdf)
2017-05-01
OPTUMIST Newsletter Summer 2017 (pdf)
2017-10-24
OPTUMIST Newsletter Winter 2018
2018-02-01
OPTUMIST Newsletter Fall 2016.pdf
2016-11-02
Optum Public Sector - The Emergency Screening Unit (ESU) located at 730 Medical Center Court in Chula Vista - IMPORTANT INFORMATION
2016-01-21
PowerPoint Presentation
2016-05-11
STANDARDS AND AGREEMENT FOR THE USE OF EVALUATOR
2015-10-09
Single Page Event Flyer with Co-Branded Logo
2018-04-06
Understanding and Diagnosing Complex Behavioral Health Conditions TERM 6-14-17.pdf
2017-05-09
Workflow for CWS Therapy Referrals (pdf)
2018-04-30
Workflow for CWS Therapy Referrals 10 28 16.pdf
2016-10-28

Forms

Child Physical Abuse Treatment Intake Assessment.docx
2018-05-10
Child Physical Abuse Treatment Quarterly Report.docx
2018-05-10
Sample Psych Testing Request Form 012016.pdf
2018-05-10
Psych Testing Request Form 012016.pdf
2018-05-10
TERM Grievance Procedures and Complaint Form Arabic.pdf
2018-05-10
TERM Grievance Procedures and Complaint Form English.pdf
2018-05-10
TERM Grievance Procedures and Complaint Form Spanish.pdf
2018-05-10
TERM Grievance Procedures and Complaint Form Tagolog.pdf
2018-05-10
COMPLAINTS ABOUT MENTAL HEALTH PROVIDERS
2015-10-09
CWS Form 04-183 Sexual Abuse Protection NPP Intake Assessment (dot)
2017-12-26
CWS Form 04-182 DV Victim Intake Assessment.dot
2016-09-30
CWS Form 04-183A Sexual Abuse Protection NPP Quarterly Progress Report.docx
2017-02-06
CWS Form 182A DV Victim Quarterly Progress Report.dot
2016-09-30
CWS Treatment Plan Form 04-176-177-Parent.dot
2016-10-11
CWS Treatment Plan Form 04-176-177-Youth.dot
2016-10-11
Foster Youth Bill of Rights (pdf)
2017-03-29
Microsoft Word - 04-178 Parent Evaluation Questions - Diagnostic Clarification and Treatment Recommendations
2016-09-30
Microsoft Word - 04-178 Parent Evaluation Questions - FC 7827
2016-09-30
Microsoft Word - 04-178 Youth Evaluation Questions - Emotional Damage Evaluation
2016-09-30
Microsoft Word - Document1
2016-09-30
Microsoft Word - Document3
2016-09-30
Microsoft Word - Document5
2016-09-30
Microsoft Word - SR 2016 0046 00 E60B583E VI.docx
2016-05-11
OptumHealth Public Sector San Diego
2016-02-24
Temporary Treatment Authorization for TERM Provider
2017-10-16
Title:
2018-01-04

DV Victims Group Treatment

DV Standards - Assessment Tools.pdf
2018-05-10
DV Standards - Documentation Requirements.pdf
2018-05-10
DV Standards - Mandatory Assessment Screening Tools Scoring Sheet.pdf
2018-05-10
DV Standards - Safety Plan Guidelines.pdf
2018-05-10
DV Victim Group Provider Specialty Criteria Form.pdf
2018-05-10
NDVH - Personalized Safety Plan.pdf
2018-05-10
TERM DV Victim Group FAQs.pdf
2018-05-10
TERM DV Victim Group Provider Fall '15 News Blast.pdf
2018-05-10
TERM DV Victim Group Provider Spring'15 News Blast.pdf
2018-05-10
TERM DV Victim Group Provider Summer'15 News Blast.pdf
2018-05-10
DV Standards - Group Intake Assessment 2015 - Sample.pdf
2018-05-10
DV Standards - Group Quarterly Progress 2015 - Sample.pdf
2018-05-10
CWS Form 04-182 DV Victim Intake Assessment.dot
2016-09-30
CWS Form 182A DV Victim Quarterly Progress Report.dot
2016-09-30
DV Standards - On Site Group Monitoring Tool (pdf)
2017-06-14
DV Victim Group Treatment Standards 9 23 16.pdf
2016-09-30
Microsoft Word - Optum Letterhead PO Box
2015-10-09
NC State University Women's Center
2015-10-09

Manuals

Court Testimony in the Juvenile Court System.pdf
2018-05-10
Delinquency System Legal Process.pdf
2018-05-10
Dependency System Legal Process.pdf
2018-05-10
Documentation Requirements.pdf
2018-05-10
Legal Issues Related to Therapy and Evaluations for CWS Cases.pdf
2018-05-10
Psychological Evaluation Procedures.pdf
2018-05-10
San Diego Juvenile Court Procedure to Obtain Authorization to Use or Disclose Protected Mental Health Information for Evaluations of Minor in Custody.pdf
2018-05-10
Specialized Optum TERM Panel Evaluations.pdf
2018-05-10
The Format and Required Elements of a CWS Psychological Evaluation.pdf
2018-05-10
The Format and Required Elements of a Juvenile Mental Competency Evaluation.pdf
2018-05-10
The Format and Required Elements of a Probation Psychological Evaluation.pdf
2018-05-10
Report of Findings 01 01 15.doc
2016-07-07
CPY Document Title
CPY Document Subject 2015-10-09
Microsoft Word - Document7
2016-09-30
Microsoft Word - Document9
2016-09-30
Probation Psychological & Psychiatric Referral
2015-10-09
Probation Psychological & Psychiatric Referral
2015-10-09
TERM Provider Handbook (pdf)
2017-09-07
TERM Treatment Plan Documentation Resources (pdf)
2018-01-24
The Format and Required Elements of a Probation Psychiatric Evaluation.pdf
2016-09-30

Quick References

CLSSD Contact List - Firm.xlsx
2018-02-01
Children’s Legal Services Vendor Invoicing Instructions (pdf)
2017-10-20
Dependency Legal Services Contact List (pdf)
2017-12-15
Dependency Legal Services Invoicing Instructions (pdf)
2017-12-15
FEBRUARY 2018 ALPHA ROSTER.xlsx
2018-02-12
FEBRUARY 2018 UNIT ROSTER.docx
2018-02-12
JANUARY 2018 ALPHA ROSTER.xlsx
2018-01-16
JANUARY 2018 UNIT ROSTER.docx
2018-01-16
June 27, 2012
2015-10-09
Medi-Cal CWS Auth Process FAQ 10 28 16.pdf
2016-10-31
Title:
2017-11-30
Workflow for CWS Therapy Referrals 10 28 16.pdf
2016-10-31

CSA NOP/NPP Treatment

CSA-NPP Assessment Tools.pdf
2018-05-10
CSA-NPP Documentation Requirements 12-1-15.pdf
2018-05-10
CSA-NPP On Site Group Monitoring Tool 12-1-15.pdf
2018-05-10
CSA-NPP Safety Plan Guidelines 11-19-15.pdf
2018-05-10
CWS Form 04-183A Sexual Abuse Protection NPP Quarterly Progress Report.docx
2017-02-06
CSA-NPP Treatment Standards 9 23 16.pdf
2016-09-30
CWS Form 04-183 Sexual Abuse Protection NPP Intake Assessment.dot
2017-12-15
MENTAL STATUS / PSYCHIATRIC SYMPTOMS
2016-03-18
MENTAL STATUS / PSYCHIATRIC SYMPTOMS
2016-03-18

Psychological Evaluations

APA Guidelines for Psych Evals In Child Protection Matters.pdf
CWS Psychological Evaluation Resources 2017-03-20
APA Speciality Guidelines Forensic Psych.pdf
TERM Psychological Evaluation Resources 2017-03-20
Microsoft Word - 04-178 Parent Evaluation Questions - Diagnostic Clarification and Treatment Recommendations
CWS Psychological Evaluation Resources 2017-03-20
Microsoft Word - 04-178 Parent Evaluation Questions - FC 7827
CWS Psychological Evaluation Resources 2017-03-20
Microsoft Word - 04-178 Youth Evaluation Questions - Emotional Damage Evaluation
CWS Psychological Evaluation Resources 2017-03-20
Microsoft Word - Document1
CWS Psychological Evaluation Resources 2017-03-20
Microsoft Word - Document3
CWS Psychological Evaluation Resources 2017-03-20
Microsoft Word - Document5
CWS Psychological Evaluation Resources 2017-03-20
Microsoft Word - Document9
CWS Psychological Evaluation Resources 2017-03-20
OptumHealth Public Sector San Diego
TERM Psychological Evaluation Resources 2017-03-20
Probation Psychological & Psychiatric Referral
Juvenile Probation Psychological Evaluation Resources 2017-03-20
Psych Testing Request Form 012016.pdf
TERM Psychological Evaluation Resources 2017-03-20
Psychological Evaluation QA Checklist (docx)
TERM Psychological Evaluation Resources 2017-04-19
Psychological Evaluation Procedures.pdf
TERM Psychological Evaluation Resources 2017-03-20
Sample Psych Testing Request Form 012016.pdf
TERM Psychological Evaluation Resources 2017-03-20
Specialized Optum TERM Panel Evaluations.pdf
Juvenile Probation Psychological Evaluation Resources 2017-03-20
TERM Psychological Evaluation Handbook (pdf)
2017-09-08
The Format and Required Elements of a CWS Psychological Evaluation.pdf
CWS Psychological Evaluation Resources 2017-03-20
The Format and Required Elements of a Juvenile Mental Competency Evaluation.pdf
Juvenile Probation Psychological Evaluation Resources 2017-03-20
The Format and Required Elements of a Probation Psychological Evaluation.pdf
Juvenile Probation Psychological Evaluation Resources 2017-03-20

CWS Treatment Plans

CWS Treatment Plan Form 04-176-177 Youth (dot)
2017-05-03
CWS Treatment Plan Form 04-176-177-Parent (dot)
2017-05-03
Documentation Requirements (pdf)
2017-05-03
Legal Issues Related to Therapy and Evaluations for CWS Cases (pdf)
2017-05-03
Microsoft Word - Document7
2017-05-03
TERM Treatment Plan Documentation Resources (pdf)
2018-01-24