2.AB3632
School Based Day Treatment Program without Children Specialized
Services Case Managers
Program
•Accepts student
•Checks Medi-Cal status
•Completes Placement
Authorization Form
•Faxes completed PA form to Chief
of CSS for signature
Chief of CSS
•Verifies AB3632 Status
•Signs PA form and places into
designated PA IN-BOX
Clerical Staff
•Faxes signed PA Form to
Program
•Distributes copies per CSS
protocol
Program
•Enters services into PSP
•Chart goes to CQRT for continued
Authorization
•Every 90 days for Intensive Day
Tx.
•Every 180 days for
Rehabilitative Day Tx.
•
Forms to use:
•PLACEMENT AUTHORIZATION FORM