TERM Providers
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.
Manuals
TERM Provider Handbook
TERM Provider Handbook Appendices
- Records Release Protocol for TERM Juvenile Probation Evaluations.pdf
- Superior Court of CA Order Authorizing Release of Health Info of Children in Custody of HHSA (expires 3-21-28).pdf
- TERM Therapy Provider Telehealth Best Practices.pdf
- Legal Issues Related to Therapy and Evaluations for CFWB Cases.pdf
- TERM Psychological Evaluation Handbook.pdf
- Claims Resources for TERM Providers.pdf
- Court Testimony in the Juvenile Court System.pdf
- Dependency System Legal Process.pdf
- CFT Information Guide for Providers.pdf
- Documentation Requirements - Group Treatment Standards.pdf
- Documentation Requirements - Individual Treatment Standards.pdf
- Juvenile Justice System Legal Process.pdf
- TERM Treatment Plan Documentation Resources.pdf
- 1. Court Testimony in the Juvenile Court System (pdf)
- 2. CFWB Form 04 176A Child Therapy Referral Form (dot)
- 3. CFWB Form 04 176A Parent Therapy Referral Form (dot)
- 4. CWS Form 04-178 Request for TERM Appointed Evaluator (pdf)
- 5. CWS Treatment Plan Documentation Resources (pdf)
- 6. CWS Form 04-176/04-177 – Parent (docx)
- 7. CWS Form 04-176/04-177 – Youth (docx)
- 8. Delinquency System Legal Process (pdf)
- 9. Dependency System Legal Process (pdf)
- 10. Documentation Requirements (pdf)
- 11. Legal Issues Related to Therapy and Evaluations for CWS Cases
- 12. Probation Psychiatric Evaluation Referral Form (pdf)
- 13. Probation Psychological Evaluation Referral Form (pdf)
- 14. Psychological Evaluation Procedures (pdf)
- 15. San Diego Juvenile Court Procedure to Obtain Authorization to Use or Disclose Protected Mental Health Information for Evaluations of Minor in Custody (pdf)
- 16. Serious Incident Report (docx)
- 17. Specialized Optum TERM Panel Evaluations (pdf)
- 18. Superior Court of the State of California Order (pdf)
- 19. The Format and Required Elements of a Probation Psychiatric Evaluation (pdf)
- 20. The Format and Required Elements of a CWS Psychological Evaluation (pdf)
- 21. The Format and Required Elements of a Juvenile Mental Competency Evaluation (pdf)
- 22. The Format and Required Elements of a Probation Psychological Evaluation (pdf)
- 23. The Format and Required Elements of a Juvenile Threat Assessment (pdf)
- CFWB Form 04-176A Child Therapy Referral Form (pdf)
- CFWB Form 04-176A Parent Therapy Referral Form (pdf)
- CFWB Treatment Plan Form for Parents 04-176_04-177p (docx)
- CFWB Treatment Plan Form for Youth (docx)
- Initial Treatment Plan/Treatment Plan Update (04-176/04-177)
- Initial Treatment Plan/Treatment Plan Update (04-176/04-177)
- Microsoft Word - 04-29cft.docx
- Microsoft Word - Psychological Evaluation Procedures.docx
- Microsoft Word - Specialized_Optum_TERM_Panel_Evaluations.docx
- Microsoft Word - The Format and Required Elements of a CFWB Psychiatric Evaluation.docx
- Microsoft Word - The Format and Required Elements of a CFWB Psychological Evaluation.docx
- Probation Psychological & Psychiatric Referral
- Request for TERM-Appointed Evaluator (pdf)
CWS Treatment
CWS Treatment Plan Forms
CWS Referral Form
Resources
- Foster Youth Bill of Rights (pdf)
- Legal Issues Related to Therapy and Evaluations for CFWB Cases (pdf)
- Microsoft Word - Legal Issues Related to Therapy and Evaluations for CFWB Cases (4.17.24).docx
- Releases of Information (ROI) - When Do I Need One for Youth Involved in the Juvenile Court Dependency System (pdf)
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
- Intimate Partner Violence Safety Plan Guidelines.pdf
- IPVV Group Psychotherapy Standards Assessment Tools.pdf
- Intimate Partner Violence Victim Group Treatment Standards.pdf
- 1. IPV Victim Group Treatment Standards (pdf)
- 2. Assessment Tools (pdf)
- 3. Documentation Requirements (pdf)
- 4. Safety Plan Guidelines (pdf)
IPV Victim Progress Reporting Forms
Resources
- IPVV On Site Group Monitoring Tool.pdf
- DV Victim Group Progress Report Sample (pdf)
- FAQ (pdf)
- IPV Victim Group Intake Assessment Sample (pdf)
- IPV Victim Group Progress Report Sample (pdf)
- IPVV Group Intake Assessment - Sample (pdf)
- Mandatory Assessment Tools Scoring Criteria (pdf)
- On Site Monitoring Tool (pdf)
- PVV Group Quarterly Progress Report - Sample (pdf)
- Personalized Safety Plan – Spanish (pdf)
- Safety Plan Samples (pdf)
CSA-NOP/NPP Treatment
CSA-NPP Treatment Standards
- NPP Safety Plan Guidelines.pdf
- NPP Group Psychotherapy Standards Assessment Tools.pdf
- 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-NPP Treatment Standards 2024 (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
- Parent Evaluation Referral Questions - Diagnostic Clarification and Treatment Recommendations (pdf)
- Parent Evaluation Referral Questions - FC7827 (pdf)
- Parent Evaluation Referral Questions - Neuropsychological Evaluation (pdf)
- Parent Evaluation Referral Questions - Prospective Adoptive Parent (pdf)
- Parent Evaluation Referral Questions - Psychiatric Evaluation (pdf)
- Youth Evaluation Referral Questions - Adoption (pdf)
- Youth Evaluation Referral Questions - Diagnostic Clarification and Treatment Recommendations (pdf)
- Youth Evaluation Referral Questions - Emotional Damage (pdf)
- Youth Evaluation Referral Questions - Neuropsychological Evaluation (pdf)
- Youth Evaluation Referral Questions - Psychiatric Evaluation (pdf)
Probation Evaluation Referral Form
Resources
- 1. TERM Psychological Evaluation Handbook (pdf)
- 2. APA Specialty Guidelines for Forensic Psychology (pdf)
- 3. APA Guidelines for Evaluations in Child Protection Matters (pdf)
- Claims Resources for CFWB Evaluations (pdf)
- TERM Psychiatric Evaluation Handbook (pdf)
- TERM Psychological Evaluation Handbook (pdf)
Medi-Cal Funded CWS Evaluations
Request to Modify CPT Code Distribution for CWS Funded Evaluations
CANS/PSC
- California Pediatric Symptom Checklist Caregiver Form - English (pdf)
- PowerPoint Presentation
- CA IP-CANS Rating Sheet - Spanish (pdf)
- CALIFORNIA INTEGRATED PRACTICE — CHILD AND ADOLESCENT NEEDS AND STRENGTHS
- CALIFORNIA INTEGRATED PRACTICE Child and Adolescent Needs and Strengths
- Electronic CANS Form.pdf
- ,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
- Children's Legal Services Contact List (pdf)
- Dependency Legal Services Contact List (pdf)
- FEBRUARY 2025 CFWB ALPHA ROSTER (xlsx)
- FEBRUARY 2025 CFWB UNIT ROSTER (docx)
- JANUARY 2025 CFWB ALPHA ROSTER (xlsx)
- JANUARY 2025 CFWB UNIT ROSTER (docx)
- MARCH 2025 CFWB ALPHA ROSTER (xlsx)
- MARCH 2025 CFWB UNIT ROSTER (docx)
TERM Updates
Grievances
Covid-19
Provider Services Info
Change of Practice Forms
Telehealth Attestation/Standards
Home Office Standards
Claims
Claims
- AMFT/ACSW/APCC Intern CFWB Billing Codes (pdf)
- Claims Resources for TERM Providers (pdf)
- LMFT/LCSW/LPCC CFWB Billing Codes (pdf)
- LMFT/LCSW/LPCC CFWB Medi-Cal Billing Codes (pdf)
- LMFT_LCSW_LPCC County of SD Billing Codes Eff 09.01.2024 (pdf)
- MD/DO CFWB Billing Codes (pdf)
- PhD/PsyD CFWB Billing Codes (pdf)
- PhD/PsyD CFWB Medi-Cal Billing Codes (pdf)
- PhD/PsyD Intern CFWB Billing Codes (pdf)
- PhD_PsyD County of SD Billing Codes Eff 09.01.2024 (pdf)