QA Manual

   
tr>
   
SECTION  
 
1
 PROVIDER TRAINING
 1-1ACBHD Provider Training Requirements Policy - ADDED 2/05/2025
 1-2PROVIDER TRAINING REFERENCE GUIDE - ADDED 2/05/2025
 
 
2
 ETHICAL CONDUCT CODE
 2-1ETHICAL CONDUCT POLICY AND PROCEDURE
 2-2MEDICARE CODE OF CONDUCT
 2-3PROFESSIONAL STANDARDS FOR MFT; MD; LCSW; & PHD PROFESSIONS
 
3
 PROFESSIONAL LICENSING WAIVERS and CREDENTIALING/RE-CREDENTIALING
 3-1CREDENTIALING AND RE-CREDENTIALING POLICY AND PROCEDURE
 3-2GUIDANCE REGARDING PROVIDER TYPES REQUIRED FOR CREDENTIALING - ADDED 4/02/2025
 3-3RESTRICTION OF PRIVILEGES FOR PRACTITIONERS (INITIAL APPLICANT)
 3-4PROFESSIONAL LICENSING WAIVER (PLW) INSTRUCTIONS AND RESOURCES - REVISED 11/20/2024
 3-5PROFESSIONAL LICENSING WAIVER FORM
 
4
 SPECIALTY SERVICES
 4-1INTENSIVE CARE COORDINATION (ICC), INTENSIVE HOME-BASED SERVICES (IHBS), AND THERAPEUTIC FOSTER CARE (TFC) - 11/05/2024
 4-2EPSDT CHART DOCUMENTATION MANUAL
 
5
 NETWORK ADEQUACY/TIMELY ACCESS REPORTING
 5-1TIMELY ACCESS TO SERVICE STANDARDS AND TRACKING REQUIREMENTS
 5-2Accessing the Timely Access Data Reporting Tool (TADT) - REVISED 2/14/2025
 5-3TADT Printable Form / TADT Fillable Form - REVISED 5/27/2025
 5-4Timely Access Data Collection Definitions FY 24-25 - REVISED 12/17/2024
 5-5Crosswalk from TADT to CSI e-Form - NEW 12/17/2024
 
6
 UNUSUAL OCCURRENCES/SENTINEL EVENTS and FORMALIZED TREND REVIEW
Note: You must be logged into the ACBH network with your username/password to use E-Forms
 6-1UNUSUAL OCCURRENCE NOTIFICATION - E-FORM, FILLABLE PDF FORM - 12/28/2023
 6-2UNUSUAL OCCURRENCE POLICY AND DEATH REPORTING POLICY - REVISED 04/25/2022
 
7
 CLINICAL RECORD DOCUMENTATION STANDARDS
 7-1CalMHSA Documentation Guides
 7-2SUPPLEMENTAL DOCUMENTATION GUIDE- SMHS - NEW 3/03/2025
 7-3MHP NETWORK PROVIDER DOCUMENTATION STANDARDS
 7-4STANDARD ABBREVIATIONS
 7-5GUIDELINES AND OPERATIONAL STANDARDS FOR CANS/ANSA TOOLS WITHIN THE MENTAL HEALTH SYSTEM OF CARE
 7-6ACBH MEDICATION CONSENT FORM - REVISED 11/2/2023
 7-7TELEHEALTH CONSENT REQUIREMENTS AND ACBH TELEHEALTH CONSENT FORM
 7-8SUICIDE HOMICIDE RISK ASSESSMENT
 7-9DHCS STANDARD SCREENING AND TRANSITION OF CARE TOOLS
 7-10MEDICATION AND PHARMACY USER GUIDE - NEW 1/23/24
 7-11ACBH PRACTICE GUIDELINES - NEW 1/23/2024
 7-12ASSESSMENT REQUIREMENTS FOR ACBH DMC-ODS PROVIDERS - NEW 2/28/24
 
8
 QUALITY ASSURANCE: AUDITS and CQRT REVIEWS
 8-1AUDIT OF MEDICAL CHARTS OF PROVIDERS OF SMHS AND NON-SMHS
 8-2CQRT PROCEDURES-SMHS and DMC-ODS - UPDATED 10/17/2023
 8-2ACQRT COMMENTS
 8-2BCQRT TRACKING TOOL
 8-2CCQRT ELECTRONIC HEALTH RECORD ATTESTATION FORM - UPDATED 12/1/22
 8-3SMHS CQRT CHECKLISTS AND GLOSSARIES
 8-3ASMHS CQRT CHECKLIST: PDF | Word - UPDATED 11/16/2023
 8-3BSMHS CQRT CHECKLIST GLOSSARY - UPDATED 11/16/23
 8-3CDMC-ODS CQRT OP AND RESIDENTIAL - UPDATED 5/31/24
 8-3DSHORT-TERM RESIDENTIAL THERAPEUTIC PROGRAM (STRTP) CQRT CHECKLIST - UPDATED 8/12/24
 8-3ESTRTP CQRT CHECKLIST GLOSSARY - UPDATED 8/12/24
 8-3F INTENSIVE CARE COORDINATION (ICC), INTENSIVE HOME-BASED SERVICES (IHBS) CQRT CHECKLIST - UPDATED 5/21/2025
 8-3GICC, IHBS CQRT CHECKLIST GLOSSARY - UPDATED 5/21/2025
 
9
 ULTIZATION MANAGEMENT PROGRAM
 9-1UTILIZATION MANAGEMENT REVIEW POLICY LEVEL I ADULT SERVICES - Forthcoming
 9-2DRUG MEDI-CAL UTILIZATION REVIEW REQUIREMENTS
 9-3UTILIZATION MANAGEMENT PROGRAM
 9-4SB785 POLICY
 
10
 BENEFICIARY RIGHTS INFORMING MATERIALS
 10-1NOTIFICATION OF BENEFICIARY RIGHTS
 10-2MEMBER HANDBOOKS
 10-3INFORMING MATERIALS PACKET
 10-4INFORMING MATERIALS PACKET- ANNUAL SIGNATURE PAGE IN ALL LANGUAGES
 10-5CONSUMER AND FAMILY GRIEVANCE PROCESS AND FORMS:
 10-6CONSUMER AND FAMILY GRIEVANCE POSTER (MULTILANGUAGES)
 10-7ADVANCE DIRECTIVE POLICY
 10-8 INFORMING MATERIALS LIST - REVISED 5/31/23
 10-9RESPONSE TO SUBPOENA FOR THE PRODUCTION OF PSYCHIATRIC AND/OR SUBSTANCE ABUSE RECORDS
 10-10CONSUMER RIGHTS GRIEVANCE: FAIR HEARING FOR SUD SERVICES
 10-11PROCEDURE FOR TEST CALLS TO ACCESS PROGRAM
 10-12NOTICE OF ADVERSE BENEFIT DETERMINATION (NOABD) POLICY - NEW 6/27/19
 
11
 CONFIDENTIALITY POLICIES
 11-1POSITION STATEMENT ON COMMUNICATION OF CLIENT INFORMATION
 11-2MANAGEMENT OF PROTECTED HEALTH INFORMATION
 11-3POLICY ON CLINICAL DATA SECURITY
 11-4PRIVACY, SECURITY AND CONFIDENTIALITY STATEMENT OF CLIENT SERVICES, RECORDS AND INFORMATION
 11-4AE-FORM FOR ACBH EMPLOYEES
 11-4BE-FORM FOR ACBH CONTRACTORS
 11-5HIPAA BREACH REPORTING POLICY
 11-5ASMARTSHEET PRIVACY INCIDENT REPORT FORM - REVISED 5/23
 11-6RECORD AND DATA RETENTION AND DESTRUCTION OF PROTECTED HEALTH INFORMATION
 11-7SECURE COMMUNICATIONS POLICY - NEW 1/2/14
 11-8RELEASE OF INFORMATION FORMS AND RESOURCES
 11-8AMH/SUD RELEASE OF INFORMATION (ROI) TRACKER LOG FORM
 11-8BMENTAL HEALTH AUTHORIZATION TO DISCLOSE INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION
 11-8CMENTAL HEALTH AUTHORIZATION TO DISCLOSE PSYCHOTHERAPY NOTES
 11-8DSUD CONSENT FORM 1- PAYMENT AND HEALTH OPERATION
 11-8ESUD CONSENT FORM 2- TREATMENT AND CARE COORDINATION
 11-8FSUD CONSENT FORM 3- MISCELLANEOUS PURPOSES
 11-8GSUD RELEASE OF INFORMATION INSTRUCTIONS
 11-8HSUD RELEASE OF INFORMATION FAQS
 
12
 SERVICE DESCRIPTIONS AND SCOPE OF PRACTICE
 12-1SERVICE DESCRIPTIONS MH AND SUD - MH, SUD - REVISED 8/15/23
 12-2MH AND SUD PROVIDER DEFINITIONS AND QUALIFICATIONS - NEW 4/22/24
 12-3ACBHD GUIDELINES FOR SCOPE OF PRACTICE (MH) - REVISED 9/20/24
 12-4ACBHD SUD Scope of Practice Reference Guide - NEW 10/28/24
 12-5MINIMUM REQUIRED SERVICE ACTIVITIES RESIDENTIAL CALAIM 3.2-WM 24-001
 12-6MINIMUM REQUIRED SERVICE ACTIVITIES RESIDENTIAL CALAIM 3.1 3.3 3.5 24-001
 12-7REQUESTING ACBHD BBS-CANDIDATE PROVIDER DESIGNATION
 
13
 SERVICE AND BILLING RESOURCES
 13-1MH LOCKOUT GRID - REVISED 7/6/23
 13-2SMARTCARE DIAGNOSIS DOCUMENT INSTRUCTIONS - NEW 11/16/23
 13-3ACBHD DIAGNOSIS AND CODE GUIDANCE - NEW 3/07/25
 13-4MH SMARTCARE PROCEDURE CODE TABLE FY 23/24 EFF. 7-1-2023 - UPDATED 4/12/24
 13-5SUD SMARTCARE PROCEDURE CODE TABLE FY 23/24 EFF. 7-1-2023 - UPDATED 8/2/23
 13-6FY24-25 PROLONGED ADD-ON AND REPLACEMENT CODES GRID - NEW 8/23/24
 13-7DHCS SERVICE TABLES FY 24-25 - NEW 8/26/24
 13-8PROFESSIONAL SERVICES EM SERVICE CODES DEFINITIONS - NEW 11/6/24
 13-9IHBS Service Table - NEW 1/27/25
 13-10MH SmartCare Procedure Code Table - FY24-25 - NEW 4/24/25
 
14
 CALIFORNIA REPORTING LAWS
 14-1POLICY ON REPORTING DEMENTING CONDITIONS
 14-2CHILDREN’S AND ADULT OUTPATIENT CLINIC POLICY REGARDING COURT ORDERED REFERRALS
 14-3ELDER/DEPENDANT ADULT ABUSE REPORTING POLICY - REVISED 5/13
 14-4CHILD ABUSE REPORTING POLICY
 14-5WARNING AND REPORTING REQUIREMENTS IN TARASOFF-LIKE SITUATIONS
 
15
 PROGRAM INTEGRITY
 15-1SERVICE VERIFICATION POLICY - NEW 11/15
 15-2 OIG and OTHER EXCLUSION LIST MONTIORING OVERSIGHT, AND REPORTING - REVISED 8/21
 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
 16-1MEDI-CAL SITE CERTIFICATION FOR PROVIDERS OF MENTAL HEALTH SERVICES POLICY - REVISED 8/15/22
 16-2MEDI-CAL SITE CERTIFICATION PROTOCOL - REVISED 8/7/24
 16-3MEDI-CAL SITE CERTIFICATION PROTOCOL: DAY TREATMENT - REVISED 8/7/24
 16-4MEDI-CAL SITE CERTIFICATION PROTOCOL: CRISIS STABILIZATION UNIT (CSU) - REVISED 8/7/24
 16-5PROVIDER CHECKLIST for MEDI-CAL CERTIFICATION OF PUBLIC SCHOOL SITES - REVISED 5/23/25
 16-6PROVIDER CHECKLIST for MEDI-CAL CERTIFICATION OF COMMUNITY BASED ORGANIZATIONS - REVISED 5/23/25
 16-7FIRE CLEARANCE REQUIREMENTS - REVISED 1/2/25
 
17
 MISCELLANEOUS POLICIES AND PRACTICES
 17-1TOBACCO POLICIES
 17-2EARLY & PERIODIC SCREENING DIAGNOSIS AND TREATMENT (EPSDT) NOTIFICATION POLICY
 17-3OBTAINING AUTH FOR PRESCRIBING PSYCH MED TO YOUTH - JV PROTECTION
  JV Forms Link
 17-4CLINICAL PSYCHIATRIC PHARMACIST SCOPE OF PRACTICE FOR MEDICATION THERAPY MANAGEMENT
 17-5GUIDELINES FOR PSYCHOTROPIC MEDICATION PRACTICES
 17-61303-1 PROVIDER PROBLEM RESOLUTION P&P
 
18
 24/7 LANGUAGE ASSISTANCE
 18-124/7 LANGUAGE ASSISTANCE TO BENEFICIARIES (1/27/20)
 18-2LANGUAGE LINE POSTER
 
19
 FREQUENTLY ASKED QUESTIONS (FAQ)
 19-1SMHS FREQUENTLY ASKED QUESTIONS - POSTED 4/11/22
 19-2CAL-AIM FREQUENTLY ASKED QUESTIONS - REVISED 12/30/22
  19-3DEPARTMENT OF HEALTH CARE SERVICES (DHCS) CALAIM BEHAVIORAL HEALTH INITIATIVE FAQ - Updated regularly by DHCS
  19-4COVID FAQ - POSTED 6/1/22
  19-5CALAIM PAYMENT REFORM FAQ - POSTED 2/6/23
 19-6HCPC/CPT CODES FAQs - REVISED 4/22/24
 
20
 TIPS SHEETS (TREATMENT INTERVENTIONS, PROTOCOLS and SUGGESTIONS)
 20-1DOCUMENTATION TIME - POSTED 1/30/25
 20-2TRAVEL TIME - - REVISED 2/18/25
 20-3INTERPRETATION SERVICE - POSTED 4/14/25
 20-4INTERACTIVE COMPLEXITY - POSTED 4/22/25
 


QA MANUAL CONTENT DISCLAIMER

QA MANUAL BINDER COVER