Documents Departmental FormsDepartmental FormsStandard Practice ManualStandard Practice ManualInformation NoticesInformation NoticesInterim Instruction Notices Interim Instruction Notices Type Name Modified Date Program and Number Actions Medi Cal Fee For Service Provider Manual MHPFFS51319 Taxonomy Codes 09/16/2021 Staff Master Worksheet Update Staff Master Worksheet Mental Health Professional Licensing Waiver Request 05/10/2021 DHCS 1739 Code of Professional Conduct for Drug and Alcohol Staff 05/10/2021 ADS001 Title 22 Fair Hearing Rights 09/23/2021 ADS002_E Title 22 Fair Hearing Rights (Spanish) 05/10/2021 ADS002_S Notice of Personal Rights / Civil Rights 05/10/2021 SUDRS003_E Notice of Personal Rights / Civil Rights – Spanish 05/10/2021 SUDRS003_S Client Annual Update Episode Summary 05/10/2021 ADS024 Client Admission Agreement 05/10/2021 SUDRS022_E Client Admission Agreement (Spanish) 05/10/2021 SUDRS022_S Substance Use Disorder and Recovery Services Intake Ass 05/10/2021 SUDRS025 Adult (Age 21 and Over) DMC-ODS Transition 05/10/2021 SUDRS026 Immediate Need Profile 05/10/2021 SUDRS027 Adult (21+) ASAM Level of Care Screening 05/10/2021 SUDRS028 Handbook Summary and Acknowledgement Form (English) 05/10/2021 SUDRS029_E Handbook Summary and Acknowledgement Form (Spanish) 05/10/2021 SUDRS029_S SUDRS-MH Grievance and Appeals Process Brochure (English) 05/10/2021 SUDRS2030_E SUDRS2030_S SUDRS-MH Grievance and Appeals Process Brochure (Spanish) 05/10/2021 SUDRS2030_S SUDRS-MH Grievance and Appeals Process Brochure-18 pt. font (Spanish) 05/10/2021 SUDRS2030-1_E SUDRS-MH Grievance and Appeals Process Brochure-18 pt. font (Spanish) 05/10/2021 SUDRS2030-1_S Adolescent (Age 12-17) and Young Adult (Age 18-20) ASAM Level of Care 05/10/2021 SUDRS031 Adolescent (Age 12-17) and Young Adult (Age 18-20) DMC-ODS Transition New! 05/10/2021 SUDRS033 SUD Referral 05/10/2021 SUDRS034 Recovery Services Plan 05/10/2021 SUDRS039 Level of Care (LOC) 05/10/2021 SUDRS042 CalOMS Youth-Detox Discharge 05/10/2021 SUDRS050 CalOMS Admission (Outpatient) 05/10/2021 SUDRS051 CalOMS Annual Update 05/10/2021 SUDRS052 Children’s Interagency Authorization to Exchange Confidential Health Information (PHI) Superseded by COM025_E 05/11/2021 CHD_INTER_E Children’s Interagency Authorization to Exchange Confidential Health Information (PHI) (Spanish) Superseded by COM025_S 05/11/2021 CHD_INTER_S Therapeutic Behavioral Services Service Assessment 05/11/2021 CHD012 Therapeutic Behavioral Services Risk Assessment 05/11/2021 CHD013 Therapeutic Behavioral Services Referral Form 05/11/2021 CHD014 Children’s Interagency Authorization to Exchange Confidential Health Information (PHI) 05/11/2021 CHD025_E Children’s Interagency Authorization to Exchange Confidential Health Information (PHI) (Spanish) 05/11/2021 CHD025_S Episode Opening and Closing Codes 05/11/2021 CLP_CODES Client Payment Agreement 05/11/2021 CLP001 Client Episode Summary (CSI) 05/11/2021 CLP002 Initial Contact Form (English) 08/26/2021 CLP003_E Initial Contact Form (Spanish) 05/11/2021 CLP003_S CSI Periodic Data 05/11/2021 CLP004 Adult Clinical Assessment (A-1) 05/11/2021 CLP005 Universal Charge Data Invoice (CDI) 05/11/2021 CLP006 Charge Data Invoice (JJOP) 05/11/2021 CLP009 Client Resource Evaluation 05/11/2021 CLP012 Adult Psychiatric Evaluation (Fillable) 05/11/2021 CLP013 Adult Psychiatric Evaluation (Printable) 05/11/2021 CLP013 Child/Adolescent Psychiatric Evaluation and Update 05/11/2021 CLP014 Child/Adolescent Clinical Assessment 05/11/2021 CLP015 Child/Adolescent Clinical Assessment-CANS-SB 05/11/2021 CLP015-1 Physical Assessment 05/11/2021 CLP016_E Physical Assessment (Spanish) 05/11/2021 CLP016_S Client Recovery Evaluation (Annual) 05/11/2021 CLP017 Request to Waive Consumer’s Responsibility to Pay for Medications 05/11/2021 CLP018 Care Necessity 05/11/2021 CLP019 Psychological Testing Referral 05/11/2021 CLP020 Healthy Homes Screening/Assessment 05/11/2021 CLP021 Diagnosis 05/11/2021 CLP022 Client Recovery Plan/ISSP 05/11/2021 CLP024_E Client Recovery Plan/ISSP (Spanish) 05/11/2021 CLP024_S Discharge Summary 05/11/2021 CLP025 Abnormal Involuntary Movement Scale 05/11/2021 CLP026 Interdisciplinary Notes 05/11/2021 CLP027 Service Team Actions 05/11/2021 CLP028 Caregiver’s Authorization Affidavit 05/11/2021 CLP029_E Caregiver’s Authorization Affidavit (Spanish) 05/11/2021 CLP029_S Request for Verification of Veterans Status for Mental Health and/or Substance Abuse Services 05/11/2021 CLP030 Consent and Authorization to Exchange Confidential Information for Veterans Status 05/11/2021 CLP031 Medication Support Services Plan 05/11/2021 CLP035_E Medication Support Services Plan (Spanish) 05/11/2021 CLP035_S Release and Hold Harmless Agreement 05/11/2021 CLP042_E Release and Hold Harmless Agreement (Spanish) 05/11/2021 CLP042_S HOST Care Plan 05/11/2021 CLP043 Interdisciplinary Care Team (ICT) Referral Form 05/11/2021 CLP044 DBH 5150-5585 Form 09/21/2021 CLP050 Columbia-Suicide Severity Rating Scale 05/11/2021 CLP051 Chart Audit Tool 05/11/2021 QM001 Annual Psychiatric Assessment Review Form 05/11/2021 QM005 Interdisciplinary Care Team (ICT) Referral Form 05/11/2021 QM018 Guidelines for Completing Referral Summary for Referral to Managed Care Plan (MCP) Attachment 05/11/2021 QM018_1 Tier Transition Letter Attachment II 05/11/2021 QM020_E Tier Transition Letter Attachment II (Spanish) 05/11/2021 QM020_S Your Rights Attachment (NOABD) 05/11/2021 QM024_E Your Rights Attachment (NOABD) (Spanish) 05/11/2021 QM024_S Your Rights Attachment (NAR) 05/11/2021 QM025_E Your Rights Attachment (NAR) (Spanish) 05/11/2021 QM025_S Beneficiary Nondiscrimination Notice 05/11/2021 QM026_E Beneficiary Nondiscrimination Notice (Spanish) 05/11/2021 QM026_S Language Assistance Taglines 05/11/2021 QM027_E Delivery System Notice (NOABD) 05/11/2021 QM029_E Delivery System Notice (NOABD) (Spanish) 05/11/2021 QM029_S Modification Notice (NOABD) 05/11/2021 QM030_E Modification Notice (NOABD) (Spanish) 05/11/2021 QM030_S Change Order Request Routing Slip 05/11/2021 QM044 State Pre-Audit Chart Review Audit Tool 05/11/2021 QM046 Change of Provider Request Form 05/11/2021 QM047_E Change of Provider Request Form (Spanish) 05/11/2021 QM047_S Request for Second Opinion QM048_E Revised! 08/24/2021 QM048_E Request for Second Opinion (Spanish) QM048_S Revised! 08/24/2021 QM048_S Mental Health and Alcohol and Drug Services Agency Evaluation 05/11/2021 QM049 Grievance Form 05/11/2021 QM050_E Grievance Form (Spanish) 05/11/2021 QM050_S Action Appeal Form 05/11/2021 QM051_E Quality Assurance Audit At Annual Point 05/11/2021 QM056 Medication Monitoring Questionnaire 05/11/2021 QM057 Denial Notice (NOABD) 05/11/2021 QM058_E Denial Notice (NOABD) (Spanish) 05/11/2021 QM058_S Termination Notice (NOABD) 05/11/2021 QM059_E Termination Notice (NOABD) (Spanish) 05/11/2021 QM059_S Timely Access Notice (NOABD) 05/11/2021 QM061_E Timely Access Notice (NOABD) (Spanish) 05/11/2021 QM061_S Medi-Cal Certification Checklist 05/11/2021 QM074 Mental Health Plan (MHP) to Medi-Cal Plan (MCP) Referral Form For Non Open Cases 05/11/2021 QM075 Financial Liability Notice (NOABD) 05/11/2021 QM078_E Financial Liability Notice (NOABD) (Spanish) 05/11/2021 QM078_S Scheduling Template 05/11/2021 CLK003 Schedule Change Request 05/11/2021 CLK004 Physician Request Form 05/11/2021 CLK006 myAvatar Program Assignment (Mental Health) 05/11/2021 CLK028 myAvatar Program Assignment (Mental Health)(Spanish) 05/11/2021 CLK028_S myAvatar CSI Assessment 05/11/2021 CLK029 myAvatar CSI Assessment (Spanish) 05/11/2021 CLK029_S myAvatar Initial Contact Form (Mental Health 05/11/2021 CLK030 myAvatar Initial Contact Form (Mental Health) (Spanish) 05/11/2021 CLK030_S Authorization to Release Protected Health Information (PHI) 08/09/2021 COM001_E Authorization to Release Protected Health Information (PHI) (Spanish) 08/23/2021 COM001_S Authorization to Release Protected Health Information (PHI) (Vietnamese) 09/15/2021 COM001_V Code of Conduct and Code of Conduct Acknowledgement 05/11/2021 COM003 Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices 05/11/2021 COM004_E Notice of Privacy Practices and Acknowledgement of Receipt of Notice of Privacy Practices (Spanish) 05/11/2021 COM004_S Certification Review Hearing – Waiver of Presence 05/11/2021 COM006 Sensitive Chart 05/11/2021 COM007 Outpatient Treatment Reauthorization Request for Adults 05/11/2021 COM010 List of Disclosures of Protected Health Information (PHI) 05/11/2021 COM012 Consent for Outpatient Treatment 05/11/2021 COM013_E Consent for Outpatient Treatment (Spanish) 05/11/2021 COM013_S Consent for Outpatient Treatment (Vietnamese) 05/11/2021 COM013_V Medical Care Authorization for Minor 05/11/2021 COM014_E Medical Care Authorization for Minor (Spanish) 05/11/2021 COM014_S Consent for Sound and/or Photographic Recordings 05/11/2021 COM015_E Consent for Sound and/or Photographic Recordings (Spanish) 05/11/2021 COM015_S Consent to Record and/or Photograph and Authorization for Use or Disclosure 05/11/2021 COM016_E Consent to Record and/or Photograph and Authorization for Use or Disclosure (Spanish) 05/11/2021 COM016_S Advance Health Care Directive 05/11/2021 COM018_E Advance Health Care Directive (Spanish) 05/11/2021 COM018_S Delegation of TX Consent 05/11/2021 COM019 Conflict of Interest Disclosure Statement 05/11/2021 COM020 Access to Medical Records Request 05/11/2021 COM021_E Access to Medical Records Request (Spanish) 05/11/2021 COM021_S Response to Request to Access Medical Records 05/11/2021 COM022_E Response to Request to Access Medical Records (Spanish) 05/11/2021 COM022_S Request to Amend Protected Health Information (PHI) 05/11/2021 COM023_E Request Request to Amend Protected Health Information (PHI) (Spanish) 05/11/2021 COM023_S Response to Request to Amend Protected Health Information (PHI) 05/11/2021 COM024_E Response to Request to Amend Protected Health Information (PHI) (Spanish) 05/11/2021 COM024_S Internal Tracking of Request to Access Medical Records 05/11/2021 COM025 Release of Information: Patient’s Right of Access to His/Her Own Medical Record 05/11/2021 COM026_E Release of Information: Patient’s Right of Access to His/Her Own Medical Record (Spanish) 05/11/2021 COM026_S Oath of Confidentiality 05/11/2021 COM027 Advance Health Care Directive (Brochure) 05/11/2021 COM028_E Advance Health Care Directive (Brochure) (Spanish) 05/11/2021 COM028_S Advance Health Care Directive (Brochure) (Vietnamese) 05/11/2021 COM028_V Privacy and Security Agreement Confidentiality Statement 05/11/2021 COM033 Tracking of PHI Records Delivered Log 05/11/2021 COM034 General Chart Room Log 05/11/2021 COM035 Ineligible Persons Policy Acknowledgement and Attestation 05/11/2021 COM036 Attestation Regarding Completion of Sanction Checks 05/11/2021 COM037 ACA 1557 Grievance Form 05/11/2021 COM038 ACA 1557 Grievance Form (Spanish) 05/11/2021 COM038_S E-Signature and Provider Signature List 05/11/2021 COM039 DBH & BBS Complaint Notifications to Clients (8-20) 05/11/2021 COM040_E DBH & BBS Complaint Notifications to Clients (8-20) (Spanish) 05/11/2021 COM040_S myAvatar Policy/Procedure Acknowledgement Form 05/11/2021 COM041 Patients’ Rights Grievance Form 05/11/2021 PR001_E Patients’ Rights Grievance Form (Spanish) 05/11/2021 PR001_S Patients’ Rights Office Grievance Appeal Form 05/11/2021 PR002_E Patients’ Rights Office Grievance Appeal Form (Spanish) 05/11/2021 PR002_S Service Authorization Request 03/01/2009 08/12/2021 MH5125 Client Assessment 03/01/2009 08/12/2021 MH5120 Client Assessment Update 03/01/2009 08/12/2021 MH5121 Client Plan 03/01/2009 08/12/2021 MH5122 Action Appeal Form (Spanish) 09/01/2021 QM051_S Request for Restriction of Confidential Communication 09/16/2021 COM030_E Request for Restriction of Confidential Communication (Spanish) 09/16/2021 COM030_S Response to Request for Restriction of Confidential Information 09/16/2021 COM031_E Response to Request for Restriction of Confidential Information (Spanish) 09/16/2021 COM031_S Type Name Modified Date Program and Number Admission Preference and Interim Services Policy SUDRS2014 Physician Consultation Services 09/13/2021 SUDRS0224 Control, Access, Accountability-Meds Supplies Policy 09/13/2021 MDS2008 Scope of Practice Billing Guide Outpatient Chart Manual Adult System of Care, Intensive and Aggressive Case Management, and ACSP Coordinated Services 05/13/2021 ADT0101 Case Management Services 05/13/2021 ADT0102 Reporting Dependent Adult/Elder Abuse and Neglect Policy 05/13/2021 ADT0103 Reporting Dependent Adult/Elder Abuse Procedure 05/13/2021 ADT0103-01 Adult System of Care Out-of-County Placement Policy 05/13/2021 ADT0105 Forensic Contraband Policy and Procedure 05/13/2021 ADT0106 DBH Alcohol and Other Drug (AOD) Programs Counselor Certification Policy 05/13/2021 ADS201 Alcohol and Drug Services Code of Professional Conduct Policy 05/13/2021 ADS0202 Title 22 Fair Hearing Rights Policy 05/13/2021 ADS0205 Medication Support Services – Alcohol and Drug Services 05/13/2021 ADS0206 Alcohol and Drug Services Program Review Procedure 05/13/2021 ADS0207 Alcohol and Drug Services Program Review Policy 05/13/2021 ADS0208 Charitable Choice Procedure 05/13/2021 ADS0209-1 Medication Policy for Clients Seeking Alcohol and Drug Treatment Services 05/13/2021 ADS0210 Alcohol and Drug Services (ADS) Admission Policy 05/13/2021 ADS0211 Alcohol and Drug Services (ADS) Youth Treatment Policy 05/13/2021 ADS0212 Alcohol and Drug Services (ADS) Perinatal Treatment Policy 05/13/2021 ADS0213 Admission Preference and Interim Services Policy 09/13/2021 SUDRS0214 Admission Preference and Interim Services Procedure SUDRS0214-1 Alcohol and Drug Services (ADS) HIV/Early Intervention Services Policy 05/13/2021 ADS0215 Alcohol and Drug Services (ADS) Primary Prevention CalOMS Reporting Policy 05/13/2021 ADS0217 Alcohol and Drug Services (ADS) Payment of Last Resort Policy 05/13/2021 ADS0218 Alcohol and Drug Services Administration Provision of TB Services Policy 05/13/2021 ADS0219 Alcohol and Drug Services (ADS) Accessibility of Service Requirements Policy 05/13/2021 ADS0220 Expenditure of the Substance Abuse Prevention and Treatment Block Grant Policy 05/13/2021 ADS0221 Substance Use Disorder Medication Safety and Effectiveness Policy 05/13/2021 SUDRS0223 Substance Use Disorder Service Utilization Policy 05/13/2021 SUDRS0225 Substance Use Disorder and Recovery Services Coordination of Care Policy 05/13/2021 SUDRS0228 Substance Use Disorder and Recovery Services Coordination of Care Procedure 05/13/2021 SUDRS0228-1 California Outcomes Measurement System 05/13/2021 SUDRS0229 California Outcomes Measurement System 05/13/2021 SUDRS0229-1 Post Client Satisfaction Survey Procedure 05/13/2021 SUDRS0230 Substance Use Disorder and Recovery Services Residential Prior Authorization Policy 05/13/2021 SUDRS0231 Drug and Alcohol Treatment Access Report Policy 05/13/2021 SUDRS0236 Drug and Alcohol Treatment Access Report Procedure 05/13/2021 SUDRS0236-1 Case Management Services for Child and Adolescent Clients 05/13/2021 CHD0302 Child Abuse Reporting Policy 05/13/2021 CHD0303 Child Abuse Reporting Procedure 05/13/2021 CHD0303-1 AB 2726 Program Policy 05/13/2021 CHD0307 Financial Interviewer Procedure 05/13/2021 CHD0308 Healthy Families SED Services Policy 05/13/2021 CHD0309 Healthy Families SED Services Procedure 05/13/2021 CHD0309-1 Providing Services to Foster Care, Adoption Assistance Program (AAP) and Kinship Guardianship Assistance Payment (KinGAP) Children Placed Out-of County Policy 05/13/2021 CHD0311 Providing Services to Foster Care Children Placed Out-of-County Procedure 05/13/2021 CHD0311-1 Providing Services to Adoption Assistance Program (AAP) and Kinship Guardianship Assistance Payment (KinGAP) Children Placed Out-of County Procedure 05/13/2021 CHD0311-2 Monitoring and Authorizing of Out-of-County Medi-cal Children Procedure 05/13/2021 CHD0314 Children’s Fund Immediate Need Voucher Policy 05/13/2021 CHD0315 Children’s Fund Immediate Need Voucher Procedure 05/13/2021 CHD0315-1 Consent for Treatment of Minors Policy 05/13/2021 CHD0316 Consent to Treat a Minor: Procedures for Parents/Legal Guardians 05/13/2021 CHD0316-1 Consent to Treat a Dependent Minor Procedure 05/13/2021 CHD0316-2 Reporting Dependent Adult/Elder Abuse and Neglect Policy 05/13/2021 ADT0103 Reporting Dependent Adult/Elder Abuse Procedure 05/13/2021 ADT0103-1 Outpatient Chart Manual (OCM) 05/13/2021 OCM Lost and Found Procedure 05/13/2021 CLK0701 Assignment of Meeting Rooms 05/13/2021 CLK0702 Clinic Responsibility for Processing Client Registration, PFI, CDI 05/13/2021 CLK0703 Charge Data Invoice (CDI) Process Procedure 05/13/2021 CLK0704 Scheduling Application Policy 05/13/2021 CLK0705 Correction of Overlapping Service 05/13/2021 CLK0707 Service Deletions and Corrections 05/13/2021 CLK0708 Initial Contact Form 05/13/2021 CLK0711 Procedure for Unscheduled Appointments 05/13/2021 CLK0712 Appointment Scheduling 05/13/2021 CLK0713 No Show Policy 05/13/2021 CLK0714 Field Trips/Conferences 05/13/2021 CLP0802 Treatment of DBH Employees by DBH Facilities 05/13/2021 CLP0804 Acknowledgement of Abuse Reporting Duties Policy 05/13/2021 CLP0805 Clinical Supervision for Licensure 05/13/2021 CLP0806 Supervision of Occupational Therapists 05/13/2021 CLP0807 Consumer Benefit Assistance Protocol 05/13/2021 CLP0808 Admission Standards for Penal Code Misdemeanor Violations 05/13/2021 CLP0809 Diagnosis of Mental Disorder 05/13/2021 CLP0810 Out-of-County Access for Mental Health Services 05/13/2021 CLP0812 Self Help Group Protocol 05/13/2021 CLP0814 Adjustment of Client Fees 05/13/2021 CLP0815 Waiver of Consumer’s Responsibility to Pay for Medications 05/13/2021 CLP0816 Policies Regarding Authorization and Designation Pursuant to the Lanterman-Petris-Short (LPS) Act 05/13/2021 CLP0818 Duty to Warn and Protect Third Parties in 05/13/2021 CLP0819 Duty to Warn and Protect Third Parties in Response to a Client Threat (Tarasoff) Procedure 05/13/2021 CLP0819-1 Day Treatment Weekly Charting in Staff Meetings 05/13/2021 CLP0821 Psychological Testing 05/13/2021 CLP0822 HIV and AIDS Charting 05/13/2021 CLP0824 Confidentiality When Dealing with Client Support Persons 05/13/2021 CLP0825 Disability Application 05/13/2021 CLP0826 Veterans Services Policy 05/13/2021 CLP0828 Veterans Services Procedure 05/13/2021 CLP0828-1 5150/5585 Transportation Policy 05/13/2021 CLP0829 5150/5585 Transportation Procedure 05/13/2021 CLP0829-1 Clients with Physical Medical Conditions Policy 05/13/2021 CLP0830 CWIC Referral Procedure 05/13/2021 CLP0831 Bus Pass Program Policy 05/13/2021 CLP0832 Shelter Bed Services Policy 05/13/2021 CLP0833 Client Substance Use Policy 05/13/2021 CLP0834 Client Substance Use Screening Procedure 05/13/2021 CLP0834-1 Transformational Collaborative Outcomes Management (TCOM) Policy 05/13/2021 CLP0836 Transformational Collaborative Outcomes Management (TCOM) Procedure 05/13/2021 CLP0836-1 Client Notice Regarding Termination of Provider Procedure 05/13/2021 CLP0837 Sending Confidential Information by Facsimile 05/13/2021 COM0901 Subpoena of Medical Records 05/13/2021 COM0902 Advance Health Care Directive Policy 05/13/2021 COM0903 Medical Records Security Policy for Outpatient Services 05/13/2021 COM904 Confidentiality of Protected Health Information (PHI) 05/13/2021 COM0905 Retention of Medical Records Policy 05/13/2021 COM0906 Unauthorized Access of Confidential Medical Records 05/13/2021 COM0907 Medical Records Requiring Special Handling 05/13/2021 COM0908 Medical Records Requiring Special Handling Procedure 05/13/2021 COM0908-1 Electronic Transfer of Client PHI 05/13/2021 COM0909 HIPAA Notice of Privacy Practices (NOPP) Policy 05/13/2021 COM0910 Conflict of Interest Policy 05/13/2021 COM0911 Authorization to Release PHI Policy 08/09/2021 COM0912 Authorization to Release Protected Health Information (PHI) Procedure 09/16/2021 COM0912-1 Trafficking Victims Protection Act of 2000 05/13/2021 COM0913 Code of Conduct 05/13/2021 COM0914 Certification of Billed Services 05/13/2021 COM0915 Compliance Verification, Monitoring and Auditing Policy 05/13/2021 COM0917 Compliance Hotline Policy 05/13/2021 COM0919 Compliance Hotline Procedure 05/13/2021 COM0919-1 DBH Compliance Committee 05/13/2021 COM0920 Sound and Photographic Recordings Policy 05/13/2021 COM0922 Security of Protected Electronic Health Information Policy 05/13/2021 COM0923 Workstation and System Security Policy 05/13/2021 COM0924 Data Integrity Policy 05/13/2021 COM0925 Privacy and Security Incident Sanctions Policy 05/13/2021 COM0926 Fraud, Waste and Abuse Prevention Policy 05/13/2021 COM0927 Access and Amendment of Medical Records Policy 05/13/2021 COM0931 Access and Amendment of Medical Records Procedure 05/13/2021 COM0931-1 Ineligible Persons Policy 05/13/2021 COM0933 Ineligible Persons Procedure 05/13/2021 COM0933-1 Compliance Plan Policy 05/13/2021 COM0934 Patients’ Rights Policy 05/13/2021 COM0935 Patients’ Rights Inpatient Grievance Process 05/13/2021 COM0935-1 Patients’ Rights Outpatient Grievance Process 05/13/2021 COM0935-2 HIPAA National Provider Identifier (NPI) Policy 05/13/2021 COM0938 HIPAA National Provider Identifier (NPI) Procedure 05/13/2021 COM0938-1 Root Cause Analysis Policy 05/13/2021 COM0939 Right to Request Alternative Means of Communication Protected Health Information Policy 05/13/2021 COM0941 Medicare Provider Certification Policy 05/13/2021 COM0942 Medi-Cal Eligibility Data Systems (MEDS) Policy 05/13/2021 COM0943 MEDS Access and Contacts Procedure 05/13/2021 COM0943-1 Privacy or Security Incident Policy 05/13/2021 COM0944 Client Grievance Policy 05/13/2021 COM0946 MHSA Issue Resolution Process 05/13/2021 COM0947 Transportation of Protected Health Information (PHI) Policy 05/13/2021 COM0948 Transportation of Protected Health Information (PHI) Procedure 05/13/2021 COM0948-1 Non-Discrimination – Section 1557 of the Affordable Care Act Policy 05/13/2021 COM0953 Affordable Care Act (ACA) 1557 Grievance Procedure 05/13/2021 COM953-1 Overpayment Policy 05/13/2021 COM0954 Behavioral Health Services for Clients/Family 05/17/2021 CUL1002 Behavioral Health Services for Clients/Family 05/17/2021 CUL1002-1 Satisfying Clients’ Language Needs 05/17/2021 CUL1004 Consumer Focus Group Policy 05/17/2021 CUL1005 Consumer Focus Group Procedure 05/17/2021 CUL1005-1 Cultural Competency Policy 05/17/2021 CUL1006 Field Testing of Written Materials Policy 05/17/2021 CUL1010 Field Testing of Written Materials Procedure 05/17/2021 CUL1010-1 Providing Translation Services Procedure 05/17/2021 CUL1011 Providing Interpretation Services Procedure 05/17/2021 CUL1012 Providing Written Communications in Threshold/Primary Languages for Consumers/Family Members Policy 05/17/2021 CUL1013 Cultural Competency Training Policy 05/17/2021 CUL1014 Medical Services Staff Organization 05/17/2021 MDS2002 Incorporated Employees – Fiscal Control Procedures 05/17/2021 MDS2003 Guidelines For Psychiatrists Assigned to Outpatient Clinics 05/17/2021 MDS2004 Leave of Absence – Physicians 05/17/2021 MDS2005 Deviation from Standard of Practice of Medicine 05/17/2021 MDS2006 Benzodiazepine Medication Policy 05/17/2021 MDS2007 Control, Access and Accountability of Medications and Medical Supplies Policy 05/17/2021 Control, Access and Accountability of Medications and Medical Supplies Procedure 2009: Medication Support Only Case Policy 05/17/2021 MDS2008-1 Controlled Substance Utilization Review and Evaluation System (CURES) Policy 05/17/2021 MDS2010 Controlled Substance Utilization Review and Evaluation System (CURES) Procedure 05/17/2021 MDS2010-1 Medication Appointment – Scheduling 05/17/2021 MDS2011 Sample Injectable Medication Policy 05/17/2021 MDS2012 Handling of Contaminated Waste/Needles and Syringes 05/17/2021 MDS2014 Prescription Policy 05/17/2021 MDS2015 Disability Application 05/17/2021 MDS2016 Consent for Administration of Psychotropic Medication to Minors Policy 05/17/2021 MDS2017 Physician’s Orders (Treatment Plan) 05/17/2021 MDS2018 Laboratory Services/Physical Assessment Policy 05/17/2021 MDS2019 Laboratory Services/Physical Assessment Procedure 05/17/2021 MDS2019-1 Medication Support Groups 05/17/2021 MDS2020 Medical Services Credentialing Procedure 05/17/2021 MDS2021 Patient Assistance Program Policy 05/17/2021 MDS2022 Patient Assistance Program Procedure 05/17/2021 MDS2022-1 Clinical Practice Guideline: Clozapine 05/17/2021 MDS2025 Telehealth Policy 05/17/2021 MDS2027 Telehealth Procedure 05/17/2021 MDS2027-1 Intranasal Naloxone Policy 05/17/2021 MDS2028 Intranasal Naloxone Procedure 05/17/2021 MDS2028-1 Medication Authorization for Dependent Children and Youth Policy 05/17/2021 MDS2029 Urgent and Emergency Conditions Procedure 05/17/2021 MDS2031 Nursing Staff Orientation Protocol 05/17/2021 NUR2101 Control and Organization of the Standard Practice Manual (SPM) Policy 05/17/2021 BOP3001 Requests to Modify the Standard Practice Manual (SPM) Procedure 05/17/2021 BOP3002 Organization of the Department 05/17/2021 BOP3003 Department Vision, Mission and Values Policy 05/17/2021 BOP3004 Communications Procedures 05/17/2021 BOP3005 Incoming Mail – Departmental 05/17/2021 BOP3006 Public Information and Media Release Policy 05/17/2021 BOP3007 Paid Advertising Procedure – General 05/17/2021 BOP3009 Legal Opinion from County Counsel 05/17/2021 BOP3010 Legislative Activities 05/17/2021 BOP3011 Reimbursement for Travel and Related Expenses 05/17/2021 BOP3012 Travel Procedure 05/17/2021 BOP3013 Benefits Team Policy 05/17/2021 BOP3014 Benefits Team Procedure 05/17/2021 BOP3014-1 Vehicle Use Policy 05/17/2021 BOP3015 Vehicle Use Procedure 05/17/2021 BOP3015-1 Maintenance – Plant & Equipment 05/17/2021 BOP3016 Purchasing Procedure 05/17/2021 BOP3017 Use of Supplies and Equipment/Notification of Loss or Damage 05/17/2021 BOP3018 Furniture and Equipment Relocation Procedure 05/17/2021 BOP3019 Surplus Inventory 05/17/2021 BOP3020 Assignment of Pagers to Divisions/Programs and Staff 05/17/2021 BOP3021 Cellular Phones 05/17/2021 BOP3022 Budget Development and Changes 05/17/2021 BOP3023 Petty Cash 05/17/2021 BOP3024 Facility Physical Security and Access Control Policy 05/17/2021 BOP3025 Facility Physical Security and Access Control Procedures 05/17/2021 BOP3025-1 Training and Tuition Reimbursement Policy 05/17/2021 BOP3026 Billing and Collection for Treatment Services Policy 05/17/2021 BOP3027 Gifts and Donations Policy 05/17/2021 BOP3029 Gifts and Donations Procedure 05/17/2021 BOP3029-1 Prepaid Cards Policy 05/17/2021 BOP3030 Prepaid Cards Procedure 05/17/2021 BOP3030-1 Guidelines for Promotional, Educational, and/or Informational Materials 05/17/2021 BOP3031 DBH Review Panel for Promotional, Educations, and/or Informational Materials 05/17/2021 BOP3032 Review of Promotional, Educational and/or Informational Materials Procedure 05/17/2021 BOP3032-1 Assignment, Closure, Merger or Relocation of Clinics Policy 05/17/2021 BOP3033 Closure of DBH Contract Provider Procedure 05/17/2021 BOP3031-1 Assignment of DBH Contract Provider Procedure 05/17/2021 BOP3033-2 Merger of DBH Contract Provider Procedure 05/17/2021 BOP3033-3 Relocation of Clinic Procedure 05/17/2021 BOP3033-4 Employee Recognition Policy 05/17/2021 BOP3037 Telecommunication Devices Policy 05/17/2021 BOP3040 Telecommunication Devices Procedures 05/17/2021 BOP3040-1 Medi-Cal Claim Certification of Authenticity Policy 05/17/2021 BOP3042 Web Blast Policy 05/17/2021 BOP3045 Web Blast Procedure and Guidelines 05/17/2021 BOP3045-1 Outreach Events Policy 05/17/2021 BOP3046 Outreach Events Procedure 05/17/2021 BOP3046-1 Approval for Filling Vacancies 05/17/2021 HR4002 Advertising Procedures – Employment 05/17/2021 HR4003 New Hire Policy 05/17/2021 HR4004 Employee Separation Procedure 05/17/2021 HR4006 Work Schedules Policy 05/17/2021 HR4007 Intra-Department Reassignment Policy (Supersedes-Employee Reassignment Requests) 05/17/2021 HR4008 Intra-Department Reassignment Procedure 05/17/2021 HR4008-1 Employment Physicals 05/17/2021 HR4009 Clinical Therapists Reassignment Request 05/17/2021 HR4010 Waiver for Pre-Licensed/Out-of-State Licensed Ready Psychologists 05/17/2021 HR4011 Registration and Licensure Requirements for Clinical Therapists 05/17/2021 HR4012 Volunteer Policy 05/17/2021 HR4013 Volunteer Request and Registration Procedure 05/17/2021 HR4013-1 Non-Discrimination / Equal Employment Opportunity 05/17/2021 HR4015 Dress and Grooming Policy 05/17/2021 HR4016 Disability Discrimination Complaints 05/17/2021 HR4017 Personnel Records 05/17/2021 HR4018 Telephone Calls – Personal 05/17/2021 HR4019 Smoking and Tobacco Use Policy 05/17/2021 HR4020 Time and Attendance Form – How to Complete 05/17/2021 HR4021 Time and Attendance Correction 05/17/2021 HR4021-1 Vacation Leave – Request 05/17/2021 HR4023 Overtime Policy 05/17/2021 HR4025 Position Transfer Reassignment & Borrowing Policy 05/17/2021 HR4026 Position Transfer Reassignment & Borrowing Procedure 05/17/2021 HR4026-1 Tuberculosis Screening Policy 05/17/2021 HR4030 Tuberculosis Screening Procedure 05/17/2021 HR4030-1 Procedure for Purchasing Computer Equipment 05/17/2021 IT5001 Request for Information Technology Support Procedure 05/17/2021 IT5002 Internet Access policy 05/17/2021 IT5003 Computer and Network Appropriate Use Policy 05/17/2021 IT5004 Electronic Mail Use Policy 05/17/2021 IT5005 Remote Access Policy 05/17/2021 IT5006 Risk Assessment Policy 05/17/2021 IT5007 Device and Media Controls Policy 05/17/2021 IT5008 User- I.D. and Password Policy 05/17/2021 IT5009 myAvatar Electronic Health Records Policy 05/17/2021 IT5012 myAvatar User Account Request Procedure 05/17/2021 IT5012-1 myAvatar User Account Creation Procedure 05/17/2021 IT5012-2 myAvatar User Account Modification Procedure 05/17/2021 IT5012-3 myAvatar User Account Deactivation Procedure 05/17/2021 IT5012-4 myAvatar User Account Reinstatement Procedure 05/17/2021 IT5012-5 Medi-Cal Site Certification Policy 05/17/2021 QM6002 Medi-Cal Site Certification Procedure 05/17/2021 QM6002-1 QShort-Doyle and Short-Doyle/Medi-Cal Clinic Change of Ownership or Location 05/17/2021 QM6003 Research and Evaluation Functions 05/17/2021 QM6004 Research Review Committee 05/17/2021 QM6005 Requesting an Initial Choice of Provider and a Change of Provider Policy 05/17/2021 QM6006 Credentialing Policy 05/17/2021 QM6008 Credentialing Procedure 05/17/2021 QM6008-1 Quality Management Committee Membership/Participation 05/17/2021 QM6009 Written Informing Materials Policy 05/17/2021 QM6012 Post State Audit Procedures 05/17/2021 QM6014 Pre State Chart Audit Responsibilities & Procedures 05/17/2021 QM6015 Procedure for Submission of Chart Documentation and Charge Data Invoices (CDIs) 05/17/2021 QM6016 Billing Guidelines for Quality Assurance Activities 05/17/2021 QM6019 Outpatient Chart Audit – Site Review Policy 05/17/2021 QM6020 Investigating and Reporting Death of a DBH Client 05/17/2021 QM6021 Quality of Care Referral Policy 05/17/2021 QM6022 Quality of Care Referral Procedure 05/17/2021 QM6022-1 SAMHSA Block Grant-Annual Program Review Procedure 05/17/2021 QM6024 Fee-For Service Credentialing Procedure 05/17/2021 QM6026 DBH Provider Directories Policy 05/17/2021 QM6027 Grievance and Appeal Policy 05/17/2021 QM6029 Grievance Procedure 05/17/2021 QM6029-1 State Hearing Procedure 05/17/2021 QM6029-2 Standard and Expedited Resolution of Appeals Procedure 05/17/2021 QM6029-3 NOABD Procedure 05/17/2021 QM6029-4 QM6032 05/17/2021 QM6032 Service Delivery Definition Policy 05/17/2021 QM6036 Consistency in Inpatient and Outpatient Utilization Review and Authorization Practices Policy 05/17/2021 QM6038 Consistency in Inpatient Utilization Review and Authorization Practices Procedure 05/17/2021 QM6038-1 Consistency in Outpatient Utilization Review and Authorization Practices Procedure 05/17/2021 QM6038-2 MHP Point of Authorization Plan for Inpatient Psychiatric Hospitalization Protocol 05/17/2021 QM6039 Tier Transition Protocol 05/17/2021 QM6040 Timely Access Policy 05/17/2021 QM6041 Timely Access Procedure 05/17/2021 QM6041-1 Network Adequacy Policy 05/17/2021 QM6043 Network Adequacy Procedure 05/17/2021 QM6043-1 Out of Network Access Policy 05/17/2021 QM6044 Out of Network Access Procedure 05/17/2021 QM6044-1 24/7 Access Line Requirements Policy 05/17/2021 QM6045 24/7 Access Line Requirements Procedure 05/17/2021 QM6045-1 Service Availability Policy 05/17/2021 QM6046 Selection and Retention of Network Provider Policy 05/17/2021 QM6048 Department Liability for Employees and Volunteers’ Action Outside Work 05/18/2021 SFT7002 Bomb Threat Procedure 05/18/2021 SFT7005 Earthquake Procedures 05/18/2021 SFT7006 Disaster and Mass Casualty Policy 05/18/2021 SFT7007 Air Pollution Emergency Episode Plan 05/18/2021 SFT7008 Assaultive Behavior Plan (ABP) Policy 05/18/2021 SFT7009 Assaultive Behavior Plan (ABP) Procedure 05/18/2021 SFT7009-1 Possession of a Weapon Policy 05/18/2021 SFT7010 Possession of a Weapon Procedure 05/18/2021 SFT7010-1 Safety and Emergency Coordination Policy 05/18/2021 SFT7011 Electrical Safety Policy: Personal Appliances 05/18/2021 SFT7012 Safety in the Field Procedure 05/18/2021 SFT7013 Threats Against Federal or State Officials Policy 05/18/2021 SFT7014 Threats and Assault on DBH Staff Policy 05/18/2021 SFT7015 Threats and Assault on DBH Staff Procedure 05/18/2021 SFT7015-1 Special Incident Reporting Procedure – Client Related 05/18/2021 SFT7016 How to Report an Incident 05/18/2021 SFT7017 Hazard Reporting Policy 05/18/2021 SFT7018 Vehicle Accidents Reporting Procedure 05/18/2021 SFT7019 Occupational Injury or Illness Reporting Procedure 05/18/2021 SFT7020 Employee General Safety Policy 05/18/2021 SFT7021 Emergency Action Plan (EAP) Policy 05/18/2021 SFT7022 Disaster Equipment Security Policy 05/18/2021 SFT7023 Kiln Policy 05/18/2021 SFT7024 Local Community Crisis Incident Response Procedure 05/18/2021 SFT7028 Office Ergonomics Intervention Program Policy 05/18/2021 SFT7029 Interagency Communication of Unusual Events Procedure 05/18/2021 SFT7032 Education and Training Policy 05/18/2021 TRA8001 Executive Training Committee Policy 05/18/2021 TRA8003 Training Payment Procedure 05/18/2021 TRA8004 Training Attendance Policy 05/18/2021 TRA8005 Training Tuition Reimbursement Policy 05/18/2021 TRA8006 Training Tuition Reimbursement Procedure 05/18/2021 TRA8006-1 Training Coordination Policy 05/18/2021 TRA8008 Training Coordination Procedure 05/18/2021 TRA8008-1 License Exam Prep Program Policy 05/18/2021 TRA8010 Index of Abbreviations 05/18/2021 Bilingual Certification Policy 08/24/2021 HR4031 Request for Second Opinion QM6053 New! 08/24/2021 QM6053 Request for Second Opinion Procedure QM6053-1 New! 08/24/2021 QM6053-1 SUDRS Master Provider File Procedure 09/07/2021 SUDRS0238 Substance Use Disorder and Recovery Services Policy 09/07/2021 SUDRS0207 Substance Use Disorder and Recovery Services Procedure 09/07/2021 SUDRS0207-1 Naloxone Intranasal Distribution Policy 09/07/2021 MDS2032 Naloxone Intranasal Distribution Procedure 09/07/2021 MDS2032-1 Admission Preference and Interim Services Policy 09/07/2021 ADS0214 Advance Health Care Directive 09/23/2021 COM005 Type Name Modified Date Notice Number Evaluation Code Changes IN 20-09 Revised Mental Health Co-Staffing Chart Documentation a 07/01/2020 IN 20-07 Personal Protective Equipment (PPE) for DBH Programs 06/01/2020 IN 20-06 Quality Management Chart Documentation Guidance due to 05/01/2020 IN 20-05 A1 DUI Guidance due to COVID-19 05/01/2020 IN 20-05 A2 NTP Guidance due to COVID-19 05/01/2020 IN 20-05 Administration Guidance due to COVID-19 05/01/2020 IN 20-05 New Classification of Other Qualified Providers 02/01/2020 IN 20-02 Suicide Prevention Training Requirement 01/01/2020 IN 20-01 Mental Health Consumer Perception Survey – Spring 2019 04/25/2019 IN 19-01 Coronavirus (COVID-19) Information for DBH Workforce 08/11/2021 IN 20-04 Mental Health Consumer Perception Survey – Spring 2019 08/12/2021 IN 19-01 DMC-ODS UCLA Treatment Perception Survey-October 2019 08/12/2021 IN 19-02 Notice of Changes to EPSDT Data Collection Requirements 08/12/2021 IN 19-04 Approved Abbreviations New! 08/12/2021 IN 19-05 Editing Notice of Adverse Benefit Determination (NOABD) 08/12/2021 IN 19-06 Mental Health Consumer Perception Survey-Fall 2019 New! 08/12/2021 IN 19-07 Consolidation of Electronic Signature (E-Signature) 08/12/2021 IN 19-08 New Medicare Beneficiary Identifier (MBI) New! 08/12/2021 IN 19-09 Network Adequacy Requirements and Deadline (03/01/2018) 08/12/2021 IN 18-01 Updated Authorization to Release Protected Health Info 08/12/2021 IN 18-02 Child and Adolescent Needs and Strengths (CANS)(PSC-35) 08/12/2021 IN 18-03 UCLA Treatment Perceptions Survey Information (9/20/18) 08/12/2021 IN 18-04 Mental Health Consumer Perception Survey – Fall 2018 08/12/2021 IN 18-05 Office Configuration Safety Standards (12/18/2018) New! 08/12/2021 IN 18-06 Standing Order Requirement for Administering NARCAN 08/12/2021 IN 18-08 Disaster Response Requirements (02/01/2017) New! 08/12/2021 IN 17-01 Revised Child/Adolescent Psychiatric Evaluation CLP014 08/12/2021 IN 17-02 SIMON Update (03/01/2017) New! 08/12/2021 IN 17-03 Regulations Regarding Welfare and Institutions Code WIC 08/12/2021 IN 17-05 CLP015-1 Child/Adolescent Assessment-CANS-SB 05/02/2017 08/12/2021 IN 17-07 Implementation of the Diagnostic and Statistical Manual 08/12/2021 IN 17-09 Medicaid Managed Care Final Rule Implementation 08/12/2021 IN 17-10 Confidentiality Statement Requirement for Safeguarding 08/12/2021 IN 17-11 Oath of Confidentiality (Contractors) (06/19/2018) 08/12/2021 IN 17-11 Appendix A Oath of Confidentiality (DBH Staff) (05/26/2018) 08/12/2021 IN 17-11 Appendix A Implementation of Title Change of Marriage and Family 08/12/2021 IN 17-12 Psychiatric Mental Health Nurse Practitioners 08/12/2021 IN 17-14 New Mental Health Procedure Codes (10/13/2016) 08/12/2021 IN 16-03 Outpatient Chart Manual and Scope of Practice Guide 08/12/2021 IN 16-02 Revised Medicare Certification Requirement (01/29/2016) 08/12/2021 IN 11-04 Electronic Mail (e-mail) Encryption (11/19/2015) 08/12/2021 IN 15-04 Contact by Outside State or Federal Agencies 08/12/2021 IN 14-12 Breining Institute Accreditation Termination 08/12/2021 IN 14-11 Guidelines for Day Treatment Intensive 08/12/2021 IN 14-10 Updates to the Scope of Practice and Billing Guide 08/12/2021 IN 14-06 Updated DBH Billing Forms and Reference Materials 08/12/2021 IN 14-09 Medi-Cal Expansion-Determining Tier III Service 08/12/2021 IN 14-05 ICD-10 Implementation Delayed (04/03/2014) 08/12/2021 IN 14-08 Medicare Updates Regarding ICD-10 (02/20/2014) 08/12/2021 IN 14-01 Medi-Cal Expansion (02/11/2014) 08/12/2021 IN 14-03 Updates to the Scope of Practice and Billing Guide 08/12/2021 IN 14-02 Updates to the Lanterman-Petris-Short (LPS) Act 08/12/2021 IN 13-13 Diagnostic and Statistical Manual of Mental Disorder 08/12/2021 IN 13-15 Discontinuance of Procedure Code 365 (11/05/2015) 08/12/2021 IN 15-02 Non-use of Blood Glucometers (06/02/2015) 08/12/2021 IN 15-01 Non-use of Blood Glucometers (06/02/2015) Marriage and Family Therapist Intern Experience 08/12/2021 IN 13-10 Board of Behavioral Sciences (BBS) Amendments 08/12/2021 IN 13-09 Care Necessity Form – Revision (09/13/2013) 08/12/2021 IN 13-08 Medicare Administrative Contract Transition 07/15/2013 08/12/2021 IN 13-07 Mental Health Plan (MHP) Contract Clarifications 08/12/2021 IN 13-05 Client Index Number (CIN) Policy Enforcement 07/02/2013 08/12/2021 IN 13-06 DBH Library Protocol (05/08/2013) 08/12/2021 IN 13-03 Accreditation of Certifying Organizations (04/30/2013) 08/12/2021 IN 13-04 Disclosure of Ownership (03/18/2013) 08/12/2021 IN 13-01 Disclosure of Ownership (03/18/2013) Changes in Charge Data Invoice (CDI) Codes (12/27/2012) 08/12/2021 IN 12-05 Outpatient Chart Manual/Initial Contact Form 12/20/2012 08/12/2021 IN 12-06 License Denied or Suspended for Failure to Pay Taxes 08/12/2021 IN 12-02 Clinical Re-Assessment (07/24/2012) 08/12/2021 IN 12-03 Requirements for Lactation Accommodations (01/06/2012) 08/12/2021 IN 12-01 (Retracted) E-Verify Program For County Contractors 08/12/2021 IN 11-14 Board Referral of Matters to County Staff (10/26/2011) 08/12/2021 IN 11-17 Medicare Certification Requirement (10/14/2011) 08/12/2021 IN 11-04 Authorization of Release of Protected Health Info 08/12/2021 IN 11-13 Sharing of Protected Health Information relating to MH 08/12/2021 IN 11-11 Medi-Cal Claims Processing Requirements When Other 08/12/2021 IN 11-10 Scope of Practice and Billing Guide (05/17/2011) 08/12/2021 IN 11-07 Updates to Universal Chart Data Invoice (CDI) Codes 08/12/2021 IN 11-06 Outpatient Chart Manual (OCM) Revision (05/09/2011) 08/12/2021 IN 11-08 Assembly Bill (AB) 583 (01/18/2011) 08/12/2021 IN 11-02 Medi-Cal Eligibility System (MEDS) (01/18/2011) 08/12/2021 IN 11-01 Generic Medication (11/19/2010) 08/12/2021 IN 10-15 Sanctions for Certification of Excluded, Suspended 08/12/2021 IN 10-14 JAG-OTP Funds (08/11/2010) 08/12/2021 IN 10-10 AMA Posting (07/14/2010) 08/12/2021 IN 10-09 Adhering to Educational Regulations (05/26/2010) 08/12/2021 IN 10-08 Providing Written Communication to Consumers/Family 08/12/2021 IN 10-07 Medicare: Forms Update & Review Process (03/01/2010) 08/12/2021 IN 10-05 Certification of Alcohol and Other Drug (AOD) Counselor 08/12/2021 IN 10-04 Simon Update for Short Doyle/Medi-Cal Phase II 08/12/2021 IN 10-03 Approval of Promotional, Educational and/or Information 08/12/2021 IN 09-11 Outpatient Chart Manual (04/08/2009) 08/12/2021 IN 09-10 Referral of Clients from Contract Agencies 08/12/2021 IN 09-06 Health Family SED Services Policy/Procedures 02/11/2009 08/12/2021 IN 09-03 Practice and Billing Guide (02/01/2009) 08/12/2021 IN 09-02 Outpatient Chart Manual (OCM) Changes (01/26/2009) 08/12/2021 IN 09-01 Inpatient Claims for Medi-Cal Recipients with other 08/12/2021 IN 08-07 Deficit Reduction Act Compliance (11/24/2008) 08/12/2021 IN 08-04 Incentive Cards Procedure and Controls (12/10/2007) 08/12/2021 IN 07-05 CDPH Orders for Behavioral Health Facilities & Workers 09/10/2021 IN 21-03 Type Name Modified Date Modified By Network Adequacy Certification Tool (NACT) (07/01/2020) 08/12/2021 IIN 20-001 Ergonomic Assessment Level (12/12/2018) New! 08/12/2021 IIN 18-001 e-Prescribing Chart Documentation (12/07/2016) New! 08/12/2021 IIN 16-001 Reporting Medical Conditions and Communicable Diseases 08/12/2021 IIN 16-002 Pill Organizers for DBH Clients (11/06/2015) 08/12/2021 IIN 15-003 ICD-10 Diagnosis and Procedure Code Transition 08/12/2021 IIN 15-002 State Requirements for Treatment Authorization Requests 08/12/2021 IIN 14-004 Electrical Safety: Personal Appliances (04/11/2014) 08/12/2021 IIN 14-002 Medication Policy and Procedure (11/20/2013) 08/12/2021 IIN 13-002 Microsoft LYNC (02/19/2013) 08/12/2021 IIN 12-006 Prepaid Debit Cards/Bus Pass Continuous Written Log 08/12/2021 IIN 12-004 Email Encryption (06/30/2011) 08/12/2021 IIN 11-002 Use of Electronic Signatures (04/22/2010) 08/12/2021 IIN 10-003 Disaster and Safety Unit (04/01/2010) 08/12/2021 IIN 10-002 Red Flags Rule (05/04/2009) 08/12/2021 IIN 09-002 Use of Episode Closing Codes (03/02/2009) 08/12/2021 IIN 09-001 myAvatar Chart Documentation Procedural Changes 09/20/2021 IN 21-002
