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Services: Mental Health & Substance Use


Interoperability & Data API Guidelines

The procedure page aims to outline guidelines for the implementation of Interoperability FHIR standards (as defined by DHCS/CalAIM initiatives) within San Mateo County’s BHRS system. The adoption of FHIR is crucial for enhancing interoperability, data exchange, and communication among various stakeholders within the behavioral health domain. 

Interoperability Objectives 

1. Facilitate seamless data exchange: FHIR implementation will enable the secure and efficient exchange of patient data between different healthcare entities within the county behavioral health system. 

2. Improve care coordination: By standardizing data formats and protocols, FHIR will support better coordination of care among behavioral health providers, primary care physicians, social services agencies, and other relevant entities. 

3. Enhance patient outcomes: Access to comprehensive and up-to-date patient information through FHIR will enable providers to make more informed decisions, leading to improved patient outcomes and quality of care. 

4. Ensure data privacy and security: The policy emphasizes compliance with relevant privacy and security regulations, such as HIPAA, to safeguard patient information during its exchange and utilization.

Infrastructure and Framework (FHIR) 

The document outlines a structured approach for implementing FHIR standards within the county behavioral health system, including technical specifications, data mapping, and integration with existing health IT infrastructure.  San Mateo County BHRS Infrastructure for FHIR is provided through our primary health care system: Netsmart. 

Governance and Oversight 

County understands that establishing governance structures and oversight mechanisms is crucial for managing FHIR implementation projects, ensuring compliance with policies, and resolving any issues or disputes that may arise. 

In observance of that need, San Mateo County relies on the guidance provided by state regulators, DHCS, county health division leadership, and county health governance committees.  San Mateo BHRS is also fully engaged in adherence to the privacy policies parameters outlined by DHCS and SUD privacy policy directed by 42 CFR Part 2.  

Link to San Mateo County BHRS: General HIPAA, Privacy and Security control/release of information release pages 

Connecting with San Mateo County BHRS Patient and Provider API’s 

County works with Netsmart to provision 3rd party access upon request. Netsmart provides the County the capability to manage this entirely. 

For full documentation, API syntax, configurations, technical requirements, parameters, and API handling: these items can be found on the Netsmart FHIR Developer Portal 

Prospective partners will have to engage by reaching out to 

County observes and supports FHIR standard v4.0.1 protocol.  

The policy defines interoperability requirements for software vendors, healthcare providers, and other stakeholders involved in the exchange of behavioral health data. 

How to Connect with county FHIR API: 
  1. A request would be made to to initiate process for review to initiate and establish connection to our FHIR API. 
  2. A county software vendor security review and assessment will likely need to be completed with vendor.   
  3. County will partner with vendor and our Netsmart system to provision/de-provision 3rd party access upon request or need.  
All API vendor/partners are expected to adhere to the following data sharing policy/procedure guidelines: 
  1. Security Risk Analysis: 
    • Compliance to ISD/HIT Security assessments, establish county software business operating agreement, and audit reviews as determined to be needed 
  2. Risk and Notification: 
    • If a determination is made that continued access or security is deemed unacceptable, county will notify the third-party application provider of the decision and remove access temporarily or permanently.  
    • Remediation is to be reviewed at the discretion of county ISD/HIT governance 
  3. Decision to Deny/Discontinue: 
    • If, after security reassessment, county reasonably determines that the security risks remain unacceptable, proceed with the decision to deny or discontinue the third-party application’s connection to the API. 
  4. Notification of Decision: 
    • Notify vendor and county partners/stakeholders, including affected users, healthcare providers, and the organization’s internal IT and security teams, about the decision to deny or discontinue API access for the specific third-party application. 
  5. Documentation: 
    • Documentation of all policy and procedure decisions to enable, remove, or terminate data share agreements are documented for HIPAA retention requirements. 
  6. Compliance: 
    • Adherence to privacy and security to BHRS privacy guidelines in regards to data sharing should be mirrored in FHIR API standards. Vendor compliance ensures that sensitive patient information is shared securely and in accordance with consent guidelines mandated by federal and state regulation: meeting the highest standards of confidentiality and data protection. Our policy emphasizes the responsible use of FHIR API, safeguarding mental health and SUD data through member consent and against unauthorized access and ensuring a trusted and interoperable healthcare environment. 
Patient Access API 

Claims and Encounter Data: 

Encounter data is mapped and referenced directly through Netsmart’s Avatar system via the FHIR portal. 

Member Claims information is populated using 835 data available in Netsmart Cal-PM and MSO modules. Only data electronically received and posted via an 835 will be listed in the EOB resource.  

  • In Netsmart’s Cal-PM module, this will be once the 835 file has been posted in the “835 Health Claim Payment/Advice” form.  
  • In Netsmart’s MSO module, this is available once an 835 is generated for the inbound 837. 
  • All data referenced within Netsmart’s interoperability calls to their modules in reporting and output is real-time 
Provider Access API 

Provider Data and 274 Provider Directory Data Requirements: 

San Mateo County BHRS commits to adhering to the 274 Provider Data Requirements set forth by state and federal regulatory agencies for Mental Health and DMC-ODS.  Data is kept real-time and reflected immediately upon requested provider updates.  This 274 data table is directly updated and entered through Netsmart’s Avatar system. 

For the Fast Healthcare Interoperability Resources (FHIR) Provider Access API, this data is directly configured to be mapped from our 274 Provider data file. This ensures the accuracy, security, and interoperability of shared provider data, emphasizing compliance with FHIR standards. We prioritize maintaining up-to-date and complete information, implementing proper security and data handling measures.  We also comply with independent, state, and federal regulatory agencies for audit and review of our reported provider data annually. 

As noted, for full API data and documentation pertaining to Patient and Provider API config items can be found on the Netsmart FHIR Developer Portal 

Security and Access Controls 

BHRS actively takes the following steps to help protect the privacy and security of their health information:  

  • Compliance to privacy and data sharing guideline measures set forth by DHCS, federal, and state governing bodies 
  • Regularly set audits for controls of data and privacy by governing boards and independent auditors 
  • Secure internal health data, HIPAA compliant vendor communications, and multifactor authentication 
  • Multiple tiers of software security monitoring and required vendor security software assessments/clearances  
  • Disaster and data loss recovery plans regularly reviewed and audited 
  • Employ secure network communication protocols 
General HIPAA-Covered Entities, Non-entities and Oversight Agencies 

HIPAA (Health Insurance Portability and Accountability Act) covers entities that handle protected health information (PHI).  

Covered entities include: 

  1. Healthcare Providers: Doctors, hospitals, clinics, psychologists, and pharmacies. 
  2. Health Plans: Health insurance companies, HMOs, company health plans, and government programs like Medicare and Medicaid. 
  3. Healthcare Clearinghouses: Entities that process nonstandard health information into a standard, interoperable format. 

Entities or individuals that generally are not covered by HIPAA include: 

  1. Employers: Employers, except in certain situations related to employee health plans. 
  2. Life Insurers: Companies providing life insurance. 
  3. Schools: Most schools, unless they provide healthcare to students through a separate healthcare provider. 

Oversight Responsibilities: 

  • Office for Civil Rights (OCR): Part of the U.S. Department of Health and Human Services (HHS), OCR enforces HIPAA privacy and security rules for covered entities. It investigates complaints and conducts audits to ensure compliance. 
  • Federal Trade Commission (FTC): The FTC plays a role in enforcing privacy and security standards for non-HIPAA-covered entities, such as mobile health apps and health-related websites. It promotes consumer protection and addresses deceptive or unfair practices. 

Submitting a Complaint to OCR: If you believe your rights under HIPAA have been violated, you can file a complaint with OCR: 

  • Online: Visit the OCR Complaint Portal on the HHS website. 
  • Mail: Send a written complaint to the appropriate regional OCR office. 

Submitting a Complaint to FTC: To file a complaint against non-HIPAA-covered entities, you can use the FTC Complaint Assistant: 

  • Online: Visit the FTC website and use the Complaint Assistant tool. 
  • Phone: Call the FTC’s Consumer Response Center. 

In both cases, providing detailed information about the incident will help the agencies investigate and address the complaint effectively. Keep in mind that the OCR and FTC work collaboratively to ensure comprehensive oversight and protection of health information privacy. 


Mental Health Services

Behavioral Health and Recovery Services provides mental health services to individuals who are eligible for Medi-Cal and/or members of the Health Plan of San Mateo through outpatient clinics in Daly City, San Mateo, the Coastside, Redwood City and East Palo Alto, in school-based locations, and through a network of community agencies and independent providers who offer outpatient services, residential treatment, rehabilitation and other services for adults and children.


COVID-19 Mental Health Resources

The coronavirus (COVID-19) pandemic is changing everyday life for us all.  For many, this means adapting to unexpected changes in our daily routines, such as school, work, social or family life, and for others, it can be even more challenging when it involves having to let go of an important event, dealing with financial pressures or facing the loss of a loved one.  Adjusting to these new realities and the uncertainties of the future, can bring about strong emotions in both adults and children that can feel overwhelming at times.


Substance Use Treatment Services

If you or a loved one is dealing with drug addiction, alcoholism, prescription drugs or chemical dependency, seeking help is the first step in recovery. As the mental health and substance use plan for Medi-Cal beneficiaries residing in San Mateo County, Behavioral Health and Recovery Services (BHRS) offers free consultation, assessment, linkages, and referrals to a network of contracted community-based substance use treatment providers throughout the County.  Call our Access Call Center for assistance at 1 (800) 686-0101, TTY (for hearing impaired): dial 711.


Crisis Services

two women - providing supportWe all want to protect the people we love, but sometimes we cannot do it on our own. If a family member or friend is in a mental health crisis and at risk of harming themselves or others, call the police – even though you or your family member may be upset or afraid – to help ensure everyone’s safety.

Find resources below that can help you and the people around you in and after a mental health emergency or crisis event.

*** See COVID-19 behavioral health information and resources here.***

If you are Experiencing a Mental Health Emergency

Call or Text 9-1-1

Call or text 9-1-1 (ask for a Crisis Intervention Trained [CIT] officer) or go to your nearest hospital emergency room if you can safely get there. See Guidelines for calling 911 in a mental health emergency to help prepare yourself.  Watch a brief video about texting 9-1-1.

Psychiatric Emergency Services

Psychiatric Emergency Services are available at:
San Mateo Medical Center
(650) 573-2662
222 West 39th Avenue, San Mateo, CA 94403

Mills-Peninsula Medical Center
(650) 696-5915
1501 Trousdale Drive, Burlingame, CA 94010


Health Insurance

Insurance keeps you healthy and financially covered when you need it most.

Health coverage can be complicated. That’s why we offer free assistance to help you apply. We can let you know which programs you may qualify for, explain how they work, what it may cost, and then help you apply.

Schedule a health coverage screening appointment even if you think you might not qualify or if you have private, non-employer sponsored insurance. Legal immigration status is not required to access free or low-cost health insurance in San Mateo County. If you are under age 26 and currently not employed, but covered by a parent’s private insurance plan, you might qualify for subsidized coverage through Medi-Cal.


Client & Family Welcome Information

Welcome to San Mateo County’s Behavioral Health and Recovery Services

In order to give you an initial orientation about the services available to you, we have carefully assembled this Welcome Packet that includes all the information you need to start accessing our network of care. 

This information is available in paper form without charge upon request. You will receive a copy within 5 business days. Please contact your provider or the BHRS ACCESS Call Center at: (800) 686-0101 or TTY (for hearing impaired): dial 711

*Providers: Items with an asterisk* must be placed in the lobby of all BHRS County and Contractor Clinics.


Client & Family Welcome Information: Chinese

歡迎來到San Mateo縣行為健康和康復服務部 (Behavioral Health and Recovery Services, BHRS)


*服務提供者: 請務必將標示星號*的物品放置在所有BHRS縣與承包商診所大廳內。



Client & Family Welcome Information: Filipino/Tagalog

Welcome sa Mga Serbisyo sa Kalusugang Nauugnay sa Pag-uugali at Pagpapagaling (Behavioral Health and Recovery Services) ng San Mateo County

Upang mabigyan ka ng panimulang oryentasyon tungkol sa mga serbisyong available sa iyo, maingat naming binuo ang Welcome Packet na ito na nagsasaad sa lahat ng impormasyong kailangan mo upang ma-access ang aming network ng pangangalaga.

*Mga Provider: Ang mga item na may asterisk* ay dapat ilagay sa lobby ng lahat ng Klinika ng County at Contractor ng BHRS.

Pain isn't always obvious. Know the Signs. Find the Words. Reach Out.  Learn the warning signs of suicide :

Suicide Prevention

Suicide is preventable. You can be the one to help.

Most people having suicidal thoughts are in a temporary, serious crisis. You can be the one to provide the support and help they need by taking three steps: know the signs of someone who is having suicidal thoughts, find the words to have a direct conversation with them and reach out for help from the many county resources available to those in crisis and their loved ones.


Community Education & Programs

Learn about and get certified in Mental Health First Aid, which helps you identify and respond to mental health crises; take a Parent Project course to learn parenting skills and get information about resources and support available in your communities; become a Health Ambassador and help other members of your community who may be experiencing symptoms of a mental illness or a substance use problem; or become a graduate of the Lived Experience Academy to empower others in furthering their healing process.


Get Involved

We offer a variety of ways to get involved to help yourself or your family, friends and community and to have a voice in the behavioral health services provided in San Mateo County.