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.

SOC and NACT Tools and Resources

COVID-19

Coronavirus Disease 2019
COVID-19 FAQs for BHS Providers
How to Manage Your Mental Health and Cope During COVID-19
CA Health Alert Network (CAHAN)


2020-04-20 - COVID Invoice Reporting Guidance (pdf)	05/06/2020	2020-05-13
2020-05-05 - BHS Provider Memo - COVID-19 Invoicing Reporting Guidelines (pdf)		2020-05-13
COVID Emergency Flexible Funds Expenditure Report (xlsx)		2020-05-13
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
Recovery Residence Census Revised (xlsx)		2020-05-13

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 - 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)		2020-04-30
NOABD Table (pdf)	Revised 01/08/2020	2020-01-08
NOABD Termination Notice - SPANISH (doc)		2020-05-08

Beneficiary


Beneficiary Non-Discrimination Notice - ENGLISH (doc)		2018-08-07
Beneficiary Non-Discrimination Notice - ENGLISH (pdf)		2018-08-07
Beneficiary Materials MHP Order Form (docx)		2019-10-04
Full Guide Farsi 2019 (pdf)	Farsi	2019-07-10
Full Guide Arabic 2019 (pdf)	Arabic	2019-07-10
Quick Guide to MH Services - Arabic (pdf)		2019-05-16
Quick Guide to MH Services - Vietnamese (pdf)		2019-05-16
Quick Guide to MH Services - Farsi (pdf)		2019-05-16
Quick Guide to MH Services - Tagalog (pdf)		2019-05-16
Quick Guide to MH Services - Spanish (pdf)		2019-05-16
Quick Guide to MH Services - English (pdf)		2019-05-16
Full Guide Tagalog 2019 (pdf)	MHP_Beneficiary_Handbook_Rv_5_01_2019_TAGALOG.pdf	2019-05-13
Full Guide Vietnamese 2019 (pdf)	MHP_Beneficiary_Handbook_Rv_5_01_2019_VIETNAMESE.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 Arabic 07-10-18.pdf	-	2019-02-07
Limited English Proficiency Poster English 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 Tagalog 07-10-18 .pdf	-	2019-02-07
Limited English Proficiency Poster Vietnamese 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 - SPANISH.doc	-	2018-08-07
NAR Adverse Benefit Determination Upheld Notice - FARSI.doc	-	2018-08-07
NAR Adverse Benefit Determination Overturned Notice - VIETNAMESE.doc	-	2018-08-07
NAR Adverse Benefit Determination Upheld Notice - TAGALOG.docx	-	2018-08-07
NAR Adverse Benefit Determination Upheld Notice - VIETNAMESE.doc	-	2018-08-07
Grievance-Appeal Brochure Farsi (pdf)		2017-11-27
NAR Your Rights State Hearing - ENGLISH.doc	-	2018-08-07
Notice of Grievance Resolution - SPANISH.doc	-	2018-08-07
NAR Adverse Benefit Determination Overturned Notice - ENGLISH.doc	-	2018-08-07
NAR Adverse Benefit Determination Upheld Notice - ARABIC.doc	-	2018-08-07
NAR Adverse Benefit Determination Upheld Notice - ENGLISH.doc	-	2018-08-07
NAR Your Rights State Hearing - FARSI.doc	-	2018-08-07
Notice of Grievance Resolution - VIETNAMESE.doc	-	2018-08-07
NAR Your Rights State Hearing - VIETNAMESE.doc	-	2018-08-07
Notice of Grievance Resolution - ENGLISH.doc	-	2018-08-07
NAR Your Rights State Hearing - SPANISH.doc	-	2018-08-07
Notice of Grievance Resolution - TAGALOG.docx	-	2018-08-07
Notice of Grievance Resolution - FARSI.doc	-	2018-08-07
Notice of Grievance Resolution - ARABIC.doc	-	2018-08-07
NAR Your Rights State Hearing - TAGALOG.docx	-	2018-08-07
NAR Your Rights State Hearing - ARABIC.doc	-	2018-08-07
NAR Your Rights State Hearing - SPANISH.pdf	-	2018-08-07
NAR Your Rights State Hearing - VIETNAMESE.pdf	-	2018-08-07
NAR Your Rights State Hearing - ARABIC.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 - TAGALOG.pdf	-	2018-08-07
Beneficiary Non-Discrimination Notice - VIETNAMESE.pdf		2018-08-06
Beneficiary Non-Discrimination Notice - TAGALOG.pdf		2018-08-06
Beneficiary Non-Discrimination Notice - VIETNAMESE.doc		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 - SPANISH.doc		2018-08-06
Beneficiary Non-Discrimination Notice - FARSI.pdf		2018-08-06
Beneficiary Non-Discrimination Notice - ARABIC.doc		2018-08-06
Beneficiary Non-Discrimination Notice - SPANISH.pdf		2018-08-06
Beneficiary Non-Discrimination Notice - TAGALOG.docx		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 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 April 2020	2020-05-05
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
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
MIS-25 Program Listing Report (xlsx)	FY 19-20 Q3	2020-05-15
MRR Tool FY 19-20 (xlsx)		2019-08-08
Medi-Cal Certification Recertification Tool (xls)		2020-05-05
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


COLLATERAL PROGRESS NOTE FORM FILL (doc)		2020-05-15
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 - Youth Interactive (pdf)	Revised 3/2020	2020-03-26
10 2018 PSC - Parent 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 (VI) 6 2018 interactive (pdf)		2020-03-25
PSC-Youth (TG) 6 2018 interactive (pdf)		2020-03-25
PSC-Youth (Arabic) 6 2018 interactive (pdf)		2020-03-25
PSC-Parent (TG) 6 2018 interactive (pdf)		2020-03-25
PSC-Youth (Farsi) 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
PRIOR AUTHORIZATION DAY SERVICES REQUEST - FORM FILL (docx)		2020-01-10
ANCILLARY SMHS REQUEST - FORM FILL (docx)		2020-01-10
UM Request Explanation (pdf)	Revised 01/01/2020	2019-12-30
UM Request Form (docx)	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 – EXPLANATION (pdf)		2019-08-20
IHBS PRIOR AUTHORIZATION REQUEST FORM FILL (docx)		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
DISCHARGE SUMMARY PAPER FORM INSTRUCTIONS (doc)	Uploaded 07-05-2019	2019-07-05
MEDICATION PROGRESS NOTE SC24 (docx)	Uploaded 07-05-2019	2019-07-05
CLIENT PLAN FORM FILL (docx)	Uploaded 07-05-2019	2019-07-05
MEDICATION PROGRESS NOTE SC25 (docx)	Uploaded 07-05-2019	2019-07-05
BHA - CHILDREN PAPER FORM INSTRUCTIONS (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
HIGH RISK ASSESSMENT EXPLANATION (docx)		2019-02-08
BHA- START FORM FILL (doc)		2019-02-08
AOA OUTPATIENT UM FORM FILL (docx)		2019-02-08
AOA OUTPATIENT UM EXPLANTION FORM (docx)		2019-02-08
BHA – ESU FORM FILL (doc)		2019-02-08
BHA – ADULT WALK IN FORM FILL (doc)		2019-02-08
PROSPECTIVE RISK ANALYSIS (PRA) EXPLANATION (docx)		2019-02-08
PROSPECTIVE RISK ANALYSIS (PRA) FORM FILL (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
FAMILY PSYCHOTHERAPY PROGRESS NOTE FORM FILL.doc		2018-07-24
FAMILY REHAB PROGRESS NOTE FORM FILL.doc		2018-07-24
CASE MANAGEMENT PROGRESS NOTE FORM FILL.doc		2018-07-24
INDIVIDUAL REHAB PROGRESS NOTE FORM FILL.doc		2018-07-24
GROUP PSYCHOTHERAPY PROGRESS NOTE FORM FILL.doc		2018-07-24
INDIVIDUAL PROGRESS NOTE OTHER FORM FILL.doc		2018-07-24
WRAPAROUND PROGRESS NOTE FORM FILL.doc		2018-07-24
ESU NURSING NOTE FORM FILL.docx		2018-07-24
MEDS MANAGEMENT LONG NOTE FORM FILL.doc		2018-07-24
GROUP REHAB 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
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


OM...Up to the Minute - May 2020 (pdf)	2020	2020-05-15
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

CCBH Login Process Tutorial available online (new)
Progress Notes and Service Codes Webinar available online (new)
NOABD Webinar available online (new)
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.


Access to Service Journal Tip Sheet 6.18.2019		2019-06-19
Collaborative Documentation Gets You Off Treadmill (pdf)		2019-01-24
Collaborative Documentation SAMHSA (pdf)		2019-01-24
Group Master Progress Note Correction Matrix (xlsx)		2018-09-05
Group Progress Note Corrections for Administrative Staff (pdf)	With Appendicies	2018-09-05
Group Progress Note Corrections for Clinical Staff (pdf)	With Appendicies	2018-09-05
Individual Master Progress Note Correction Matrix (xlsx)		2018-09-05
MHRS and Parapro Documentation Practicum (pptx)	Powerpoint Presentation	2019-05-22
New Program Manager Orientation - Powerpoint Slides (pdf )	Issued 03/30/2020	2020-04-01
Progress Note Corrections for Admin and Clinical Staff - Presentation (pdf)		2018-05-18
Progress Note Corrections for Adminstrative Staff (pdf)	With Appendicies	2018-09-05
Progress Note Corrections for Clinical Staff (pdf)	With Appendicies	2018-09-05
Progress Notes Resource Packet (pdf)	Updated March 2019	2019-03-14

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