providing mental health &
substance abuse  services for
the people of Alameda County ...  
   

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QA Manual

   

   
SECTION  
 
1
 QUALITY MANAGEMENT AND IMPROVEMENT PROGRAM*
 1-1ACBHCS ORGANIZATIONAL CHART
 
  *OTHER CONTENT FOR THIS SECTION IS UNDER REVIEW
 
2
 ETHICAL CONDUCT CODE
 2-1ETHICAL CONDUCT POLICY AND PROCEDURE
 2-2MEDICARE CODE OF CONDUCT
 2-3SUPERVISION AND PROFESSIONAL STANDARDS POLICY *FORTHCOMING UNDER REVIEW
 2-4PROFESSIONAL STANDARDS FOR MFT; MD; LCSW; & PHD PROFESSIONS
 
3
 CREDENTIALING AND RE-CREDENTIALING
 3-1CREDENTIALING AND RE-CREDENTIALING POLICY AND PROCEDURE
 3-2RESTRICTION OF PRIVILEGES FOR PRACTITIONERS (INITIAL APPLICANT)
 3-3PROFESSIONAL LICENSING WAIVER POLICY AND PROCEDURE
 3-4MEMO FROM QA RE: DMH LETTER NO. 10-03 WITH ATTACHMENTS
 3-5PROFESSIONAL LICENSING WAIVER FORM
 
4
 PROVIDER PROBLEM RESOLUTION
 4-1Provider Problem Resolution and Appeals
 
5
 NETWORK ADEQUACY/TIMELY ACCESS REPORTING
 5-1DMC-ODS AND SMHS TIMELY ACCESS DATA COLLECTION DEFINITIONS - 5/2/2023
  • DMC-ODS: Also see “Substance Use Disorder (SUD) Timely Access Data Collection” section on the QA Training page
  • SMHS: Also see “Network Adequacy- Client Service Information (CSI) Data Documentation” section on the QA Training page
 
6
 UNUSUAL OCCURRENCES/SENTINEL EVENTS and FORMALIZED TREND REVIEW
 6-1UNUSUAL OCCURRENCE NOTIFICATION FORM - REVISED 4/19/2023
 6-2UNUSUAL OCCURRENCE POLICY AND DEATH REPORTING POLICY - REVISED 04/25/2022
 
7
 CLINICAL RECORD DOCUMENTATION STANDARDS
 7-1CalMHSA Documentation Guides
 7-2CLINICAL RECORD DOCUMENTATION STANDARDS for SMHS
 7-3MHP NETWORK PROVIDER DOCUMENTATION STANDARDS
 7-4STANDARD ABBREVIATIONS
 7-5EPSDT CHART DOCUMENTATION MANUAL
 7-6Service Descriptions - Mental Health Service Definitions & Examples
 7-7Guidelines and Operational Standards for CANS/ANSA Tools Within the Mental Health System of Care
 7-8ACBH Guidelines for Scope of Practice Credentialing (MH)
 7-9ACBH Medication Consent Form
 7-10Mental Health Medi-Cal Lockout Grid
 7-11Telehealth Consent Form - Word, PDF
 
8
 QUALITY ASSURANCE: AUDITS and CQRT REVIEWS
 8-1AUDIT OF MEDICAL CHARTS OF PROVIDERS OF SMHS AND NON-SMHS
 8-2CQRT Procedures Post Cal-AIM - UPDATED 4/6/2023
 8-2ACQRT Checklist: PDF | Word (DOCM) - UPDATED 1/19/2023
 8-2BCQRT Checklist Glossary - UPDATED 1/19/2023
 8-2CCQRT Comments Sheet
 8-2DCQRT Tracking Tool
 8-2ECQRT Electronic Health Record Attestation Form - UPDATED 12/1/2022
 
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
 10-3HOW TO USE INFORMING MATERIALS PACKET
 10-3AINFORMING MATERIALS PACKET- English
 10-3BINFORMING MATERIALS PACKET- Chinese Traditional
 10-3CINFORMING MATERIALS PACKET- Farsi
 10-3DINFORMING MATERIALS PACKET- Spanish
 10-3EINFORMING MATERIALS PACKET- Vietnamese
 10-3FINFORMING MATERIALS PACKET- Chinese Simplified
 10-3GINFORMING MATERIALS PACKET- Korean
 10-3HINFORMING MATERIALS PACKET- Tagalog
 10-3IINFORMING MATERIALS PACKET - ARABIC
 10-3JINFORMING MATERIALS PACKET- ANNUAL SIGNATURE PAGE IN ALL LANGUAGES
 10-4CONSUMER GRIEVANCE AND APPEAL PROCESS FOR MEDI-CAL SMHS AND MHSA PROGRAMS
 10-4ACONSUMER AND FAMILY GRIEVANCE FORMS - English - Revised 12/15/2022
 10-4BCONSUMER AND FAMILY GRIEVANCE FORMS - Farsi
 10-4CCONSUMER AND FAMILY GRIEVANCE FORMS - Spanish
 10-4DCONSUMER AND FAMILY GRIEVANCE FORMS - Chinese Simplified
 10-4ECONSUMER AND FAMILY GRIEVANCE FORMS - Chinese Traditional
 10-4FCONSUMER AND FAMILY GRIEVANCE FORMS - Vietnamese
 10-4GCONSUMER AND FAMILY GRIEVANCE FORMS - Tagalog
 10-4HCONSUMER AND FAMILY GRIEVANCE FORMS - Korean
 10-5CONSUMER AND FAMILY GRIEVANCE POSTER (MULTILANGUAGES)
 10-6ADVANCE DIRECTIVE POLICY
 10-8INFORMING MATERIALS LIST - Revised 2/2/23
 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 5/2023
 11-6Record and Data Retention and Destruction of Protected Health Information
 11-7SECURE COMMUNICATIONS POLICY - NEW, 1/2/14
 
12
 CONSUMER SATISFACTION SURVEY
 12-1CONSUMER SATISFACTION SURVEY
 
13
 VOTER REGISTRATION POLICY AND PROCEDURE
 13-1VOTER REGISTRATION POLICY AND PROCEDURE
 13-2VOTER REGISTRATION APPLICATION
 
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 MAY, 2013
 14-4CHILD ABUSE REPORTING POLICY
 14-5WARNING AND REPORTING REQUIREMENTS IN TARASOFF-LIKE SITUATIONS
 
15
 PROGRAM INTEGRITY
 15-1SERVICE VERIFICATION POLICY - NEW 11/2015
 15-2 OIG and OTHER EXCLUSION LIST MONTIORING OVERSIGHT, AND REPORTING - Revised 8/2021
 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 9/16/22
 16-3MEDI-CAL SITE CERTIFICATION PROTOCOL: DAY TREATMENT - Revised 9/16/2022
 16-4MEDI-CAL SITE CERTIFICATION PROTOCOL: CRISIS STABILIZATION UNIT (CSU) - Revised 9/16/2022
 16-5PROVIDER CHECKLIST for MEDI-CAL CERTIFICATION OF PUBLIC SCHOOL SITES - Revised 1/23/23
 16-6PROVIDER CHECKLIST for MEDI-CAL CERTIFICATION OF COMMUNITY BASED ORGANIZATIONS - Revised 1/17/23
 16-7FIRE CLEARANCE REQUIREMENTS - Revised 5/5/22
 
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
 17-6Timely Access to Service Standards and Tracking Requirements
 
18
 24/7 Language Assistance
 18-1CULTURALLY AND LINGUISTICALLY PROFICIENT SERVICES
 18-1ALanguage Line Solutions Implementation Memo - 5-24-19
 18-1BLanguage Line Solutions: Partnering with an Interpreter
 18-1COn Demand Interpreting is Fast and Easy
 18-1DSample Quick Reference Guide
 18-2Language Line Poster
 18-324/7 Language Assistance to Beneficiaries (1/27/20)
 
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 - Revised 2/28/2023
  19-4COVID FAQ - Posted 6/1/2022
  19-5CalAIM Payment Reform FAQ - Posted 2/6/2023


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