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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
PROFESSIONAL LICENSING WAIVERS and CREDENTIALING/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 (PLW)Policy
-
5/2/2023
3-4
DHCS Instructions for PLW (attached)
3-5
PROFESSIONAL LICENSING WAIVER FORM
3-6
DHCS PROFESSIONAL LICENSING WAIVER RESOURCES
4
PROVIDER PROBLEM RESOLUTION
4-1
PROVIDER PROBLEM RESOLUTION AND APPEALS
5
NETWORK ADEQUACY/TIMELY ACCESS REPORTING
5-1
DMC-ODS AND SMHS TIMELY ACCESS DATA COLLECTION DEFINITIONS
5-2
CSI Assessment Record Data FAQs
5-3
CSI Sharefile Request - Fillable
5-4
CSI Timeliness Training Manual
5-5
CSI Timeliness Data Collection Form with instructions
5-6
CSI Assessment Record Data Screens Onboarding Instructions
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
6-1
UNUSUAL OCCURRENCE NOTIFICATION -
E-FORM
,
FILLABLE PDF FORM
-
12/28/2023
6-2
UNUSUAL OCCURRENCE POLICY AND DEATH REPORTING POLICY
-
REVISED 04/25/2022
7
CLINICAL RECORD DOCUMENTATION STANDARDS
7-1
CalMHSA Documentation Guides
7-2
CLINICAL RECORD DOCUMENTATION STANDARDS for SMHS
7-3
MHP NETWORK PROVIDER DOCUMENTATION STANDARDS
7-4
STANDARD ABBREVIATIONS
7-5
EPSDT CHART DOCUMENTATION MANUAL
7-6
GUIDELINES AND OPERATIONAL STANDARDS FOR CANS/ANSA TOOLS WITHIN THE MENTAL HEALTH SYSTEM OF CARE
7-7
ACBH MEDICATION CONSENT FORM
-
REVISED 11/2/2023
7-8
TELEHEALTH CONSENT REQUIREMENTS AND ACBH TELEHEALTH CONSENT FORM
English -
Word
,
PDF
Arabic -
Word
,
PDF
Chinese Tradition -
Word
,
PDF
Chinese Simplified -
Word
,
PDF
Farsi -
Word
,
PDF
Korean -
Word
,
PDF
Spanish -
Word
,
PDF
Tagalog -
Word
,
PDF
Vietnamese -
Word
,
PDF
7-9
SUICIDE HOMICIDE RISK ASSESSMENT
7-10
DHCS STANDARD SCREENING AND TRANSITION OF CARE TOOLS
7-11
MEDICATION AND PHARMACY USER GUIDE
- NEW 1/23/24
7-12
ACBH PRACTICE GUIDELINES
- NEW 1/23/2024
7-13
ASSESSMENT REQUIREMENTS FOR ACBH DMC-ODS PROVIDERS
- NEW 2/28/24
8
QUALITY ASSURANCE: AUDITS and CQRT REVIEWS
8-1
AUDIT OF MEDICAL CHARTS OF PROVIDERS OF SMHS AND NON-SMHS
8-2
CQRT PROCEDURES-SMHS and DMC-ODS
- UPDATED 10/17/2023
8-2A
SMHS CQRT CHECKLIST:
PDF
|
Word
- UPDATED 11/16/2023
8-2B
SMHS CQRT CHECKLIST GLOSSARY
- UPDATED 11/16/23
8-2C
DMC-ODS CQRT OP AND RESIDENTIAL
- UPDATED 5/31/24
8-2D
CQRT COMMENTS SHEET
8-2E
CQRT TRACKING TOOL
8-2F
CQRT ELECTRONIC HEALTH RECORD ATTESTATION FORM
- UPDATED 12/1/22
8-2G
SHORT-TERM RESIDENTIAL THERAPEUTIC PROGRAM (STRTP) CQRT CHECKLIST
- UPDATED 8/12/24
8-2H
STRTP CQRT CHECKLIST GLOSSARY
- UPDATED 8/12/24
9
ULTIZATION MANAGEMENT PROGRAM
9-1
UTILIZATION MANAGEMENT REVIEW POLICY LEVEL I ADULT SERVICES - Forthcoming
9-2
DRUG MEDI-CAL UTILIZATION REVIEW REQUIREMENTS
9-3
UTILIZATION MANAGEMENT PROGRAM
9-4
SB785 POLICY
10
BENEFICIARY RIGHTS INFORMING MATERIALS
10-1
NOTIFICATION OF BENEFICIARY RIGHTS
10-2
BENEFICIARY HANDBOOKS
English
Spanish
Arabic
Chinese (Traditional)
Chinese (Simplified)
Farsi
Vietnamese
Korean
Tagalog
10-3
HOW TO USE INFORMING MATERIALS PACKET
English
Spanish
Arabic
Chinese (Traditional)
Chinese (Simplified)
Farsi
Vietnamese
Korean
Tagalog
10-4
INFORMING MATERIALS PACKET- ANNUAL SIGNATURE PAGE IN ALL LANGUAGES
10-5
CONSUMER GRIEVANCE AND APPEAL PROCESS FOR MEDI-CAL SMHS AND MHSA PROGRAMS
10-6
CONSUMER AND FAMILY GRIEVANCE FORMS
- REVISED 12/15/2022
English
Spanish
Arabic
Chinese (Traditional)
Chinese (Simplified)
Farsi
Vietnamese
Korean
Tagalog
10-7
CONSUMER AND FAMILY GRIEVANCE POSTER (MULTILANGUAGES)
10-8
ADVANCE DIRECTIVE POLICY
10-9
INFORMING MATERIALS LIST
- REVISED 5/31/23
10-10
RESPONSE TO SUBPOENA FOR THE PRODUCTION OF PSYCHIATRIC AND/OR SUBSTANCE ABUSE RECORDS
10-11
CONSUMER RIGHTS GRIEVANCE: FAIR HEARING FOR SUD SERVICES
10-12
PROCEDURE FOR TEST CALLS TO ACCESS PROGRAM
10-13
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
SMARTSHEET PRIVACY INCIDENT REPORT FORM
- REVISED 5/23
11-6
RECORD AND DATA RETENTION AND DESTRUCTION OF PROTECTED HEALTH INFORMATION
11-7
SECURE COMMUNICATIONS POLICY
- NEW 1/2/14
11-8
RELEASE OF INFORMATION (ROI) TRACKER LOG FORM
12
SERVICE DESCRIPTIONS AND SCOPE OF PRACTICE
12-1
SERVICE DESCRIPTIONS MH AND SUD -
MH
,
SUD
-
REVISED 8/15/23
12-2
MH AND SUD PROVIDER DEFINITIONS AND QUALIFICATIONS
- NEW 4/22/24
12-3
ACBHD GUIDELINES FOR SCOPE OF PRACTICE (MH)
-
REVISED 9/20/24
12-4
ACBH GUIDELINES FOR SCOPE OF PRACTICE CREDENTIALING (SUD)
12-5
MINIMUM REQUIRED SERVICE ACTIVITIES RESIDENTIAL CALAIM 3.2-WM 24-001
12-6
MINIMUM REQUIRED SERVICE ACTIVITIES RESIDENTIAL CALAIM 3.1 3.3 3.5 24-001
13
SERVICE AND BILLING RESOURCES
13-1
MH LOCKOUT GRID
-
REVISED 7/6/23
13-2
SMARTCARE DIAGNOSIS DOCUMENT INSTRUCTIONS
- NEW 11/16/23
13-3
ACBH SMHS OP ICD-10-CM DIAGNOSES FOR CLAIMING
- NEW 11/16/23
13-4
ACBH SUD OP ICD-10-CM DIAGNOSES FOR CLAIMING
- NEW 11/16/23
13-5
BHIN 20-043 ENCLOSURE 1 - SMHS INPATIENT INCLUDED DIAGNOSIS
- NEW 11/16/23
13-6
BHIN 20-074E ENCLOSURE 1 - SUD RESIDENTIAL AND INPATIENT INCLUDED DIAGNOSIS
- NEW 11/16/23
13-7
MH SMARTCARE PROCEDURE CODE TABLE FY 23/24 EFF. 7-1-2023
- UPDATED 4/12/24
13-8
SUD SMARTCARE PROCEDURE CODE TABLE FY 23/24 EFF. 7-1-2023
- UPDATED 8/2/23
13-9
FY24-25 PROLONGED ADD-ON AND REPLACEMENT CODES GRID
- NEW 8/23/24
13-10
DHCS SERVICE TABLES FY 24-25
- NEW 8/26/24
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 5/13
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 11/15
15-2
OIG and OTHER EXCLUSION LIST MONTIORING OVERSIGHT, AND REPORTING
- REVISED 8/21
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
- REVISED 8/15/22
16-2
MEDI-CAL SITE CERTIFICATION PROTOCOL
- REVISED 8/7/24
16-3
MEDI-CAL SITE CERTIFICATION PROTOCOL: DAY TREATMENT
- REVISED 8/7/24
16-4
MEDI-CAL SITE CERTIFICATION PROTOCOL: CRISIS STABILIZATION UNIT (CSU)
- REVISED 8/7/24
16-5
PROVIDER CHECKLIST for MEDI-CAL CERTIFICATION OF PUBLIC SCHOOL SITES
- REVISED 9/4/24
16-6
PROVIDER CHECKLIST for MEDI-CAL CERTIFICATION OF COMMUNITY BASED ORGANIZATIONS
- REVISED 9/4/24
16-7
FIRE CLEARANCE REQUIREMENTS
- REVISED 8/12/24
17
MISCELLANEOUS POLICIES AND PRACTICES
17-1
TOBACCO POLICIES
17-2
EARLY & PERIODIC SCREENING DIAGNOSIS AND TREATMENT (EPSDT) NOTIFICATION POLICY
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
GUIDELINES FOR PSYCHOTROPIC MEDICATION PRACTICES
17-6
TIMELY ACCESS TO SERVICE STANDARDS AND TRACKING REQUIREMENTS
18
24/7 LANGUAGE ASSISTANCE
18-1
24/7 LANGUAGE ASSISTANCE TO BENEFICIARIES (1/27/20)
18-2
LANGUAGE LINE POSTER
19
FREQUENTLY ASKED QUESTIONS (FAQ)
19-1
SMHS FREQUENTLY ASKED QUESTIONS
- POSTED 4/11/22
19-2
CAL-AIM FREQUENTLY ASKED QUESTIONS
-
REVISED 12/30/22
19-3
DEPARTMENT OF HEALTH CARE SERVICES (DHCS) CALAIM BEHAVIORAL HEALTH INITIATIVE FAQ
-
Updated regularly by DHCS
19-4
COVID FAQ
-
POSTED 6/1/22
19-5
CALAIM PAYMENT REFORM FAQ
-
POSTED 2/6/23
19-6
HCPC/CPT CODES FAQs
-
REVISED 4/22/24
QA MANUAL CONTENT DISCLAIMER
QA MANUAL BINDER COVER