Community Behavioral Health Services - San Francisco Department ...

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Eligibility-Related Terminology:Assets: The financial resources currently owned by, or available to, the client. These include bank accounts,IRAs, stocks, property, etc. Assets are one of the basic eligibility criteria for CAAP, SSI, CAPI and Medi-Cal.Income: The amount of money received by the client on a regular (or irregular) basis. It includes earnedincome (salary) and unearned income (SSDI, SDI, LTD payments). Income does not affect eligibility, but doesaffect Share of Cost (see below).Living Arrangement: This term applies to the situation in which a client lives, and can refer to thecommunity, SNF (skilled nursing facility), B&C (board-and-care home), SRO (single-room occupancy hotel),etc. A client on SSI receives a different amount of SSI based on his or her living arrangement.Share of Cost (SOC): This term is used essentially by the Medi-Cal program and can best be described as amonthly deductible. A client’s SOC is determined by subtracting the Maintenance Need ($620) from theclient’s income, and the remainder is the SOC. This amount must be paid to a provider each month beforeMedi-Cal begins to be billable for services.Note: The financial amounts used as examples above refer to single adults, and are greater for marriedcouples.For More Eligibility-Related Information, Advocacy and Technical Assistance:Bay Area Legal Aid: www.baylegal.orgCenter for Medicare Advocacy, Inc.: www.medicareadvoacy.orgGA Advocacy Project: www.gaap.orgHealth Insurance Counseling and Advocacy Program: www.lashicap.orgHomeless Advocacy Project: www.sfbar.org/volunteer/opportunities.aspx#anchor05Legal Services Corporation: www.lsc.govNational Health Law Program, Inc.: www.healthlaw.orgNational Immigration Law Center: www.nilc.orgNational Law Center on Homelessness and Poverty: www.nlchp.orgNational Senior Citizens Law Center: www.nsclc.orgNational Organization of Social Security Claimants’ Representatives: www.nosscr.orgPositive Resource Center: www.positiveresource.orgWestern Center on Law and Poverty: www.wclp.orgDPH Disability Evaluation and Advocacy Project: 865-5250HSA Disability Evaluation and Consultation Unit: 558-4340HSA Medi-Cal Office: 558-100091
Medical Necessity Requirements for Mental Health & Substance AbuseTo be eligible to receive CBHS services, a beneficiary must be a resident of San Francisco, have a medicallynecessary diagnosis, and have an assessment of financial need and support for services, i.e., third-partyinsurance status or lack thereof. A Beneficiary must also meet the criteria outlined in each of the following formental health and substance abuse:Specific Requirements for Mental Health (CCR, Title 9, sections 1830.205 & 1830.210)SUBDIVISIONS(1) DSM–IV Disorder: (2) Impairment: (3) Intervention:Must have one of the followingdisorders:(A) Pervasive DevelopmentalDisorders, except AutisticDisorders(B) Disruptive Behavior andAttention Deficit Disorders(C) Feeding and Eating Disorders ofInfancy and Early Childhood(D) Elimination Disorders(E) Other Disorders of Infancy,Childhood, or Adolescence(F) Schizophrenia and otherPsychotic Disorders(G) Mood Disorders(H) Anxiety Disorders(I) Somatoform Disorders(J) Factitious Disorders(K) Dissociative Disorders(L) Paraphilias(M) Gender Identity Disorder(N) Eating Disorders(O) Impulse Control Disorders NotElsewhere Classified(P) Adjustment Disorders(Q) Personality Disorders, excludingAntisocial Personality Disorder(R) Medication–Induced MovementDisorders related to otherincluded diagnoses.Must have at leastone of the followingimpairments as a resultof the mental disorder(s)listed in Subdivision (1):(A) Significantimpairment in animportant area of lifefunctioning.(B) Probability ofsignificantdeterioration in animportant area of lifefunctioning.(C) Except as providedbelow*, a probabilitythat a child will notprogressdevelopmentally asindividuallyappropriate. (For thepurpose of thissection, a child is aperson under theage of 21 years).Must meet each of theintervention criteria listed below:(A) The focus of the proposedintervention is to address thecondition identified inSubdivision (2).(B) The expectation is that theproposed intervention will:1. Significantly diminish theimpairment, or2. Prevent significantdeterioration in an importantarea of life functioning, or3. Except as provided below*,allow the child to progressdevelopmentally as individuallyappropriate.(C) The condition would not beresponsive to physical healthcare-based treatment.(D) When the requirements of thissection are met, beneficiariesshall receive specialty mentalhealth services for a diagnosisincluded in Subsection (1)even if a diagnosis that is notincluded in Subsection (1) isalso present.*Beneficiaries under 21 years of age, who meet all other requirements but who do not meet the requirementsdetailed in Subdivision (2) and (3) may still be eligible to receive CBHS services. Please call Behavioral HealthAccess Center at 255-3737 for these authorization requirements.92
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City and County of San Fr ancisco
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CBHS 2010-2011 Provider ManualA wel
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Who is Served by the San Francisco
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Children, Youth, & Family (CYF) - M
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CYF Mental Health and School Partne
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Residential, Sub-acute and Communit
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Adult and Older Adult - Mental Heal
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CBHS Pharmacy ServiceAll clients wh
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Supportive Housing and Shelter-Base
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AOA Outpatient ServicesDesigned to
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Substance Abuse Service ProvidersDr
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Substance Abuse Outpatient Treatmen
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Driving Under the Influence (DUI) p
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AARS - Comprehensive Outreach Proje
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Alternatives Program Damon Eaves, L
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Joe Healy Medical Detox Project off
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This program provides mental health
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Languages: SpanishCATS MAP Mobile A
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Children’s System of Care (CSOC)
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Languages: Amharic, Arabic, Cantone
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Provides specialized neurobehaviora
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Languages: SpanishDSAAM Office Base
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Epiphany Center for Families in Rec
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and to develop a community support
Page 52 and 53: Languages: Basic translation servic
Page 54 and 55: 1440 Chinook Ct. #A San Francisco C
Page 56 and 57: Evaluation Consultation Unit (DECU)
Page 58 and 59: 2 year transitional house setting f
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Page 62 and 63: Languages: Spanish, Russiansome res
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Page 66 and 67: vocational rehabilitation, housing
Page 68 and 69: Languages: SpanishProgress Foundati
Page 70 and 71: Languages: Amharic, Cantonese, Mand
Page 72 and 73: i-Ability IT Training - Serves SF C
Page 74 and 75: severely and persistently mentally
Page 76 and 77: Seneca Center Community TreatmentFa
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Page 82 and 83: (SED), neglected, or abused childre
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Page 90 and 91: Westside Ajani (RU#38CP3 )Shona Bau
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Page 94 and 95: CBHS Policies, Procedures, andAdmin
Page 96 and 97: • New! Fiscal-Cost Reporto ADP Co
Page 98 and 99: Patients’ RightsMental Health (La
Page 100 and 101: Basic Benefit Eligibility OverviewB
Page 104 and 105: Specific Requirements for Substance
Page 106 and 107: CBHS Client Grievance ProcedureCBHS
Page 108 and 109: Adult and Older Adult QOC FormCity
Page 110 and 111: Children QOC FormCITY AND COUNTY OF
Page 112 and 113: Staff ID and Service and Billing Pr
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Page 116 and 117: Substance Abuse Staff Professional
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Page 120 and 121: PH Harm Reduction Policyolicy Numbe
Page 122 and 123: DPH Privacy Policy Matrix forSharin
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Page 128 and 129: If a patient has not requested that
Page 130 and 131: • Avatar CANS Treatment Plan Step
Page 132 and 133: OverviewThe Contract Compliance Sec
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Page 137 and 138: Counselor Certification Regulations
Page 139 and 140: Behavioral Health Court: A program
Page 141 and 142: COSIGCo-Occurring State Incentive G
Page 143 and 144: psychologists, social workers, and
Page 145 and 146: Intensive Case Management: Intensiv
Page 147 and 148: NOANPINPPESNREPPNTPOBICOBOTNotice o
Page 149 and 150: Recovery:Process by which people ar
Page 151 and 152: TCMTEDSTIPTargeted Case Management
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Steven Dempsey Peer Support/ Client
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Toni Rucker Director, Grants & Trai
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Community Behavioral Health Services - San Francisco Department ...

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