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QA Manual

SECTION       1   QUALITY MANAGEMENT AND IMPROVEMENT PROGRAM*   1-1 ACBHCS ORGANIZATIONAL CHART       *OTHER CONTENT FOR THIS SECTION IS UNDER REVIEW   2   ETHICAL CONDUCT CODE   2-1 ETHICAL CONDUCT POLICY AND PROCEDURE   2-2 MEDICARE CODE OF CONDUCT   2-3 SUPERVISION AND PROFESSIONAL STANDARDS POLICY *FORTHCOMING UNDER REVIEW   2-4 PROFESSIONAL STANDARDS FOR MFT; MD; LCSW; & PHD PROFESSIONS   3   CREDENTIALING AND RE-CREDENTIALING   3-1 CREDENTIALING AND RE-CREDENTIALING POLICY AND PROCEDURE   3-2 RESTRICTION OF PRIVILEGES FOR PRACTITIONERS (INITIAL APPLICANT)   3-3 PROFESSIONAL LICENSING WAIVER POLICY AND PROCEDURE   3-4 MEMO FROM QA RE: DMH LETTER NO. 10-03 WITH ATTACHMENTS   3-5 PROFESSIONAL LICENSING WAIVER FORM   4   PROVIDER PROBLEM RESOLUTION   4-1 Provider Problem Resolution and Appeals   5   PRACTITIONER PROFILING   5-1 INDEPENDENT PRACTITIONER PROFILING SYSTEM   5-2 ACBHCS CREDENTIALS COMMITTEE’S PRACTITIONER PROFILING   6   UNUSUAL OCCURENCES/SENTINEL EVENTS and FCR   6-1 FORMALIZED CASE REVIEW POLICY - REVISED 12/2015   6-2 UNUSUAL OCCURRENCE AND DEATH REPORTING POLICY - REVISED 12/2015   6-3 UNUSUAL OCCURRENCE AND DEATH REPORTING FORM - REVISED   6-3A UNUSUAL OCCURRENCE AND DEATH REPORTING FORM - MSWORD TEMPLATE   6-4 UNUSUAL OCCURRENCE_DEATH REPORTING COMPARISON SHEET - NEW   7   CLINICAL RECORD DOCUMENTATION STANDARDS   7-1 CLINICAL RECORD DOCUMENTATION STANDARDS for SMHS   7-2 MHP NETWORK PROVIDER DOCUMENTATION STANDARDS - REVISED   7-3 STANDARD ABBREVIATIONS   7-4 EPSDT CHART DOCUMENTATION MANUAL   7-5 PROGRESS NOTE POLICY AND PROCEDURE - Progress Notes for Mental Health Services   7-6 Service Descriptions - Mental Health Service Definitions & Examples   7-7 Guidelines and Operational Standards for CANS/ANSA Tools Within the Mental Health System of Care   8   QUALITY ASSURANCE REVIEW: AUDITS   8-1 AUDIT OF MEDICAL CHARTS OF PROVIDERS OF SMHS AND NON-SMHS   8-2A SMHS CQRT Regulatory Compliance Tool (15%)   8-2B SMHS CQRT Regulatory Compliance Tool (85%)   9   ULTIZATION MANAGEMENT PROGRAM   9-1 CLINICAL/QUALITY REVIEW TEAM REVIEW POLICY AND PROCEDURE MANUAL (CQRT)   9-1A CQRT ADULT FORM   9-2 UTILIZATION MANAGEMENT REVIEW POLICY LEVEL I ADULT SERVICES - Forthcoming   9-3 DRUG MEDI-CAL UTILIZATION REVIEW REQUIREMENTS   9-4 UTILIZATION MANAGEMENT PROGRAM   9-5 SB785 POLICY   10   BENEFICIARY RIGHTS INFORMING MATERIALS   10-1 NOTIFICATION OF BENEFICIARY RIGHTS   10-3 HOW TO USE INFORMING MATERIALS PACKET   10-3A INFORMING MATERIALS PACKET- English   10-3B INFORMING MATERIALS PACKET- Chinese Traditional   10-3C INFORMING MATERIALS PACKET- Farsi   10-3D INFORMING MATERIALS PACKET- Spanish   10-3E INFORMING MATERIALS PACKET- Vietnamese   10-3F INFORMING MATERIALS PACKET- Chinese Simplified   10-3G INFORMING MATERIALS PACKET- Korean   10-3H INFORMING MATERIALS PACKET- Tagalog   10-31 INFORMING MATERIALS PACKET- ANNUAL SIGNATURE PAGE   10-4 CONSUMER GRIEVANCE AND APPEAL PROCESS FOR MEDI-CAL SMHS AND MHSA PROGRAMS   10-4A CONSUMER AND FAMILY GRIEVANCE FORMS - English   10-4B CONSUMER AND FAMILY GRIEVANCE FORMS - Farsi   10-4C CONSUMER AND FAMILY GRIEVANCE FORMS - Spanish   10-4D CONSUMER AND FAMILY GRIEVANCE FORMS - Chinese Simplified   10-4E CONSUMER AND FAMILY GRIEVANCE FORMS - Chinese Traditional   10-4F CONSUMER AND FAMILY GRIEVANCE FORMS - Vietnamese   10-4G CONSUMER AND FAMILY GRIEVANCE FORMS - Tagalog   10-4H CONSUMER AND FAMILY GRIEVANCE FORMS - Korean   10-5 CONSUMER AND FAMILY GRIEVANCE POSTER   10-6 ADVANCE DIRECTIVE POLICY   10-7 ADVANCE DIRECTIVE BOOKLET - YOUR RIGHTS AND RESPONSIBILITIES Korean Translation - NEW Tagalog Translation - NEW   10-8 INFORMING MATERIALS LIST   10-9 RESPONSE TO SUBPOENA FOR THE PRODUCTION OF PSYCHIATRIC AND/OR SUBSTANCE ABUSE RECORDS   10-10 Consumer Rights Grievance: Fair Hearing for SUD Services   10-11 Procedure for Test Calls to ACCESS Program   10-12 Notice of Adverse Benefit Determination (NOABD) Policy - New 6/27/19   11   CONFIDENTIALITY POLICIES   11-1 POSITION STATEMENT ON COMMUNICATION OF CLIENT INFORMATION   11-2 MANAGEMENT OF PROTECTED HEALTH INFORMATION   11-3 POLICY ON CLINICAL DATA SECURITY   11-4 Privacy, Security and Confidentiality Statement of Client Services, Records and Information   11-4a E-Form for ACBH Employees   11-4b E-Form for ACBH Contractors   11-5 HIPAA BREACH REPORTING POLICY   11-5A ACBH Privacy Incident Reporting Form - New 3/2020   11-6 RECORD STORAGE AND RETENTION POLICY & PROCEDURE - Refer to our Clinical Documentation standards for guidance on the topic   11-7 SECURE COMMUNICATIONS POLICY - NEW, 1/2/14   12   CONSUMER SATISFACTION SURVEY   12-1 CONSUMER SATISFACTION SURVEY   13   VOTER REGISTRATION POLICY AND PROCEDURE   13-1 VOTER REGISTRATION POLICY AND PROCEDURE   13-2 VOTER REGISTRATION APPLICATION   14   CALIFORNIA REPORTING LAWS   14-1 POLICY ON REPORTING DEMENTING CONDITIONS   14-2 CHILDREN’S AND ADULT OUTPATIENT CLINIC POLICY REGARDING COURT ORDERED REFERRALS   14-3 ELDER/DEPENDANT ADULT ABUSE REPORTING POLICY - REVISED MAY, 2013   14-4 CHILD ABUSE REPORTING POLICY   14-5 WARNING AND REPORTING REQUIREMENTS IN TARASOFF-LIKE SITUATIONS   15   PROGRAM INTEGRITY   15-1 SERVICE VERIFICATION POLICY - NEW 11/2015   15-2 OIG and OTHER EXCLUSION LIST MONTIORING OVERSIGHT, AND REPORTING - Revised 3/2018 May 2016 Memo Regarding Exclusion List Monitoring & Monthly Provider Attestation August, 2014 Draft Office of Inspector General (OIG) Policy August, 2014 Memo Regarding the OIG Policy and Procedure from the Director of ACBHCS   15-3 WHISTLEBLOWER PROGRAM FOR FRAUD, WASTE, AND ABUSE   15-4 WHISTLEBLOWER REPORTING FORM   15-5 WHISTLEBLOWER POSTER   15-6 ACBH COMPLIANCE AND PROGRAM INTEGRITY PLAN   15-7 CONTRACT COMPLIANCE AND SANCTIONS FOR BHCS-CONTRACTED PROVIDERS   16   MEDI-CAL SITE CERTIFICATION   16-1 MEDI-CAL SITE CERTIFICATION FOR PROVIDERS OF MENTAL HEALTH SERVICES POLICY   16-2 MEDI-CAL SITE CERTIFICATION PROTCOL   16-3 MEDI-CAL SITE CERTIFICATION PROTOCOL, “HOW TO”   16-4 PUBLIC SCHOOL MEDI-CAL SITE CERTIFICATION PROCEDURE   16-5 PROVIDER CHECKLIST for MEDI-CAL CERTIFICATION OF PUBLIC SCHOOL SITES   16-6 PROVIDER CHECKLIST for MEDI-CAL CERTIFICATION OF NON-SCHOOL SITES   16-7 FIRE CLEARANCE NOTIFICATION w/ FORM FILLABLE OCCUPANCY INSPECTION REQUEST FORM (Public School Based Sites Only) STANDARD OCCUPANCY INSPECTION REQUEST FORM (Public School Based Sites Only)   16-8 COVID-19 Waiver Site Cert INSERT   17   MISCELLANEOUS POLICIES   17-1 TOBACCO POLICIES   17-2 EARLY & PERIODIC SCREENING DIAGNOSIS AND TREATMENT (EPSDT) NOTIFICATION POLICY - Posted 1/9/14   17-3 OBTAINING AUTH FOR PRESCRIBING PSYCH MED TO YOUTH - JV PROTECTION     JV Forms Link   17-4 CLINICAL PSYCHIATRIC PHARMACIST SCOPE OF PRACTICE FOR MEDICATION THERAPY MANAGEMENT   17-5 Timely Access to Service Standards and Tracking Requirements   18   24/7 Language Assistance   18-1 CULTURALLY AND LINGUISTICALLY PROFICIENT SERVICES   18-1A Language Line Solutions Implementation Memo 5-24-19   18-1B Language Line Solutions: Partnering with an Interpreter   18-1C On Demand Interpreting is Fast and Easy   18-1D Sample Quick Reference Guide   18-2 Language Line Poster QA MANUAL CONTENT DISCLAIMER QA MANUAL BINDER COVER