5.
DSS/ Residential RCL 12 w/Day Treatment w/BHCS Contracts
b. Out-Of-County
(Including Adoption Assistance Program* placements,
Excluding Project Destiny placements)
Program
•Coordinates admission to program
with DSS
•Check Medi-Cal status
•Complete the Placement
Authorization (PA) Form and Day Treatment
Authorization Criteria Form and turn into RCL 13/14 Coordinator for
signature
RCL 13/14 Coordinator
•RCL 13/14 Coordinator places
signed PA Form into designated PA in-
box
Clerical Staff
•Faxes signed PA Form to
Program
•Distributes copies per in-house
Placement Authorization In Box
Procedure