9. Therapeutic Pre-School
Program
•Assesses client for admission to
program
•Check Medi-Cal status
•Complete the Placement
Authorization (PA) Form and Criteria for 0-5 Early
Childhood Mental Health and turn into Early Childhood Mental Health
Coordinator for signature
Early Childhood Mental Health
Coordinator
•Signs PA Form and distributes to
Program, PST and QA
Program
•Enters services into PSP
•Chart goes to CQRT for continued
Authorization
Ø Every
90 days for Intensive Day Tx.
Ø Every
180 days for Rehabilitative Day Tx.
Forms to use:
•PLACEMENT AUTHORIZATION
FORM
•CRITERIA FOR 0-5 EARLY CHILDHOOD
MENTAL HEALTH