Behavioral Health Staff: County SOC Contractors
San Mateo County Mental Health System of Care Contractors
Mental Health Services
Below is a brief outline of essential procedures to ensure accurate documentation and billing for clients who are beneficiaries of San Mateo County and addresses only documents and authorizations which must be provided to San Mateo County Behavioral Health and Recovery Services. Please review our Documentation Manual for SMHS and the Documentation Checklist for more detailed information about San Mateo County documentation requirements.
Quick Links to Policies
Assessment Documents:
-
CalAIM Assessments PDFs - These versions will be officially implemented as of 12/9/2024. Contractors may begin using these forms prior to official implementation.
- CalAIM Youth Assessment PDF – Updated 11/19/2024
- CalAIM Adult Assessment PDF – Updated 11/19/2024
- Additional Required Assessment Forms
- CANS and PSC -35
- Sexual Orientation and Gender Identify: SOGI, SOGI Instructions – The SOGI questions are embedded into the CalAIM Assessment forms above.
- Pre-CalAIM Assessment PDFs – These versions will be
retired as of 12/9/2024.
- Initial Assessment: Youth Initial, Adult Initial
- Reassessment: Youth Reassessment, Adult Reassessment
- Assessment Addendum
- Diagnosis
Treatment Plan Documents:
- Client Treatment & Recovery Plan: BHRS Client Treatment & Recovery Plan
- Client Treatment & Recovery Plan Addendum
Progress Note & Services
- BHRS Progress Note Form – Updated 9/18/2024
Financial/MIS:
- Payor Financial: English Spanish
- Registration Form (MIS) – Updated 9/18/2024
- Discharge Form (MIS) – Updated 9/18/2024
TBS
- TBS Referral Form
- TBS Reporting Form: PDF Excel
- TBS Services Request
- TBS UM Tool
Out Of County Authorization Forms
Medical Certification
- New Short-Doyle/Medi-Cal Provider Certification Application: PDF Word - Fax to BHRS Quality Management at (650) 573-2841
Client Registration
Within one week after client enters program, fax registration form to MIS. You will then receive a Client Dashboard. There will be useful information on this document, including the client’s mental health number, care coordinator for this client, current open episodes, annual due (anniversary) date, which may or may not coincide with child’s entry into your program.
Client Treatment Plans and Assessments
For children/youth in a foster care, KinGAP or Aid to Adoptive Parents (AAP) aid code placed outside their county of origin, providers are required to use the State’s standard documents (Client Assessment, Client Plan, Service Authorization Request, client assessment update, progress notes – day treatment intensive/day rehabilitation services) developed by the Department of Mental Health. This does not change any of the existing timelines as specified below. State Out-of-County Placement Forms for SB785
- If client is currently open to SMC system, within 2 months:
- Obtain a copy of the Child/Youth Admission Assessment done by San Mateo County and retain it in the client’s chart, review assessment and complete update as needed. For children/youth in a foster care, KinGAP or Aid to Adoptive Parents (AAP) aid code placed outside their county of origin, providers are required to complete the Client Assessment developed by the Department of Mental Health.
- Fax the following three items to MIS at (650)
573-2110. You may use your agency’s Client Treatment
Plan for this purpose only after approval by SMC QI. For
children/youth in a foster care, KinGAP or Aid to Adoptive
Parents (AAP) aid code placed outside their county of origin,
providers are required to complete the Client Plan developed
by DMH. Plan must be signed and dated by client and/or
relevant caregiver, or noted as to when and why unable to
obtain signature. Plan must be signed and dated by LPHA.
- Client Treatment Plan
- Assessment Form and LOCUS (if not on Assessment)
- If this client is new to SMC system, within 2 months:
- Complete the Initial Assessment according to the protocol defined in the San Mateo Mental Health Documentation Manual. You may use your own assessment form for this purpose only after approval by SMC QI. For children/youth in a foster care, KinGAP or Aid to Adoptive Parents (AAP) aid code placed outside their county of origin, providers are required to complete the Client Assessment developed by DMH.
- Fax the following items to MIS at (650) 573-2110.
- Client Treatment Plan
- Assessment Form and LOCUS (if not on Assessment)
- Note Carefully the Annual Due Date
- This date is generated by client’s entry into SMC system. It is always the First of the Month. If case was previously open, it could be as soon as within the next month. If client is new to our system, this date will be the first day of the month he or she entered your program.
- Client Treatment Plan must be completed and signed on the Annual Due Date or any time during the six weeks prior to that date. Fax to MIS at (650) 573-2110. If your agency is the Care Coordinator, complete the SMC Annual Assessment. For children/youth in a foster care, KinGAP or Aid to Adoptive Parents (AAP) aid code placed outside their county of origin, providers are required to complete the Client Assessment Update developed by DMH. Fax to MIS at (650) 573-2110.
- Fax Client Treatment Plan and Assessment Form and LOCUS (if not on Assessment) verifying covered services.
Authorizations
Note that authorization timelines do not necessarily coincide with documentation requirement timelines. Retain template format as provided by SMC.
For children/youth in a foster care, KinGAP or Aid to Adoptive Parents (AAP) aid code placed outside their county of origin, providers are required to complete the Service Authorization Request developed by DMH.
A. Initial Authorizations
Fax or mail completed and signed Initial Authorization Request to (650) 872-3626 within two weeks (not more than 30 days) following child’s entry to Program. You will receive notification of services authorized. If client has a SMC Case Manager, this person may have completed the request, and you should have received the authorization. Always verify that you have an authorization signed by SMC in place.
B. Re-authorizations
Fax or mail completed and signed Re-authorization Request to (650) 872-3626 at least two weeks (not more than 30 days) prior to end date of previous authorization. Services will not be authorized retroactively. The clinician completing this form should always review previously completed authorizations as they may contain comments relevant to future requests.
Important Reports
Your agency will receive monthly reports notifying you of the following: due dates for client plans and assessments, documents which are overdue, and unbillable services resulting from inadequate documentation. It is your responsibility to designate someone to monitor these reports and ensure that San Mateo County has accurate information of who should receive them. Please make sure this information gets to the clinician responsible for completing relevant documents in order to prevent revenue loss.