Organizational Provider Resources

Forms

  1. Clients - Adults and Children
  2. Clients - Children Only
  3. Informing Materials
  4. NOABDs
  5. Practitioner Enrollment
  6. QI
  7. Referral, Authorization, Claim
  1. 1006 ROI
  2. 1006S ROI Spanish
  3. 1013 Client Information Form Annual Update
  4. 1014 Client Plan
  5. 1028 Health History Questionnaire
  6. 1042 Outpatient Medication Advisement
  7. 1061 HCBH Adult Referral Form
  8. 1096 Assessment
  9. 1127 Client Information Form
  10. 1173 Mental Status Exam
  11. 1195 Informed Consent for Outpatient Services
  12. 1196 Informing Materials Packet-Client Acknowledgement
  13. 1232 Continuity of Care Request
  14. 4017 Text Messaging Communications Consent

Policies & Procedures

  1. 0100.300 Suspected Child Abuse and Neglect Reporting
  2. 0100.301 Suspected Dependent Adult and Elder Abuse Reporting
  3. 0100.302 Duty to Protect
  4. 0100.604 Access to Interpreters and Competent Providers
  5. 0100.610 Long Term Care Beneficiary
  6. 0406.101 Access to Services
  7. 0704.0460 Client Problem Resolution Process
  8. 0704.341 Medi-Cal Site Certifications-Recertifications
  9. 0704.370 QM Chart Review
  10. 0704.390 ASOC Outpatient Services Authorization of Day Treatment Services
  11. 0704.420 Beneficiary Rights
  12. 0704.500 Notice of Adverse Benefit Determination
  13. 0704.540 Provider Problem Resolution Process
  14. 0704.660 OOC Hospitalizations
  15. 0704.871 Access To Services For Clients Out Of County
  16. 0704.873 Auth of Out-of-Plan Services For Foster Care, Aid to Adoptions and Kin-GAP Children
  17. 0704.875 Continuity of Care
  18. 0704.877 Distribution Of Informing Materials
  19. 0704.878 Provider Selection, Certification and Re-Certification
  20. 0704.879 Required Documents by Contract Providers
  21. 0704.880 Out of County Provider Documentation Monitoring
  22. 0704.881 Notice to Clients of Provider Contract Termination
  23. 0704.882 Accessible Client Materials Policy
  24. 0704.980 Staff Worksheet
  25. 1001.005 CANS-Humboldt
  26. 1001.100 Request for Access to Services CFS
  27. 1001.200 Authorization and Referral Process for In County IHBS
  28. 1001.800 Client Service Authorization and Exit Criteria
  29. 0100.599 Pre-Assessment Support to Access Outpatient Services
  30. 0704.670 ARTS Authorization
  31. 0704.671 CRTS Authorization
  32. 0704.680 Outpatient SMHS Authorization

Training Guides and Manuals

  1. Behavioral Health Cultural Awareness Training (YouTube video)
  2. CANS-Humboldt Guide
  3. NOABD Training
  4. Outpatient Documentation Manual 2019
  5. TBS Coordination of Care Best Practices Manual October 2010
  6. TBS Documentation Manual October 2009