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Policy Number
Policy Description
Policy Number
Policy Description
104 Compliance Plan 419 Purchases of Bus Passes Tickets
120 Notice of Adverse Benefit Determination Forms 421 Referral of Cases to Behavioral Health Division Adult Services
123 Unusual Incident Reporting 422 Utilization Review
128 Beneficiary Problem Resolution Process (Grievance, Standard Appeals, Expedited Appeals) 432 Adult Services Case Management Representative Payee Services Delegation Of Authority For Representative Payee Services
129 Medical Records Documentation 433 AS CM Rep Payee Services Eligibility
130 Practice Guidelines 434 CM Rep Payee Services Intake Procedure
144 Disclosure of Unlicensed Status for License Eligible Clinicians 435 Representative Payee Case Action
145 Productivity (formerly known as “Expected Levels of Achievement”) 436 Adult Services Case Management Representative Payee Services Reporting Responsibilities To Social Security Administration
146 Sentinel Events 437 Adult Services Case Management Representative Payee Services Deceased Client Accounts
147 Out of Network 148 Network Adequacy and Timeliness Standards
149 Telehealth

202 Safety Practices for Field Visits 438 Medical Waste Management
207 441 Medication Refills
208 ASAM Training 443 Scope of Practice
300 Reporting of Child Abuse and Neglect 444 Physician Availability
300B Reporting of Elder And Dependent Adult Abuse 452 Distribution of Translated Materials
301 Filming Photographing Audio of Clinical Activities 454 Reporting of Quality Improvement Time
304 Direct Patient Access to Treatment Records 457 & 457B TBS & TBS Eligibility
305 Patient’s Rights 460 Mobile Crisis Services
306 471 Advance Health Care Directive
307 Reporting of Lapses of Consciousness 477 Therapy Dogs
310 Contact With The News Media 478 Milestones of Recovery

480 Natividad Medical Center Mental Health unit Record Documentation Policy
312 Firearms Possession 490
314 Subpoenas 492 Co-Signatures
319 Onset of Services 493 QI Action Request
320 494 Service Verification Policy Procedure
321 Obtaining Authorization to Use, Exchange, and Disclose Confidential Behavioral Health Information 495 Projects within MCBH
322 Protected Health Information Breach Notification and Mandatory Reporting 496 Electronic Communication System
324 Consent for Minors by Parent Legal Guardian When Parents are Divorced 497 Master & Bachelor Level Internship Program (MCBH)
333 Involuntary Treatment for Individuals with Mental Health Disorders 498 Verification of Work Experience Hours
334 Staff Authorized to Initiate Involuntary Holds 499 Continuum of Care
335 Assessing and Initiating 5150 in Outpatient and Integrated Care Clinics 500 Consent for Psychotropic Medication
336 Advisement of Rights to Involuntary Patients (5250) 501 Psychotropic Medication Monitoring Plan
337 Risk Assessment of Minors in School Setting 506
350 & 350-B 507 Prescription of Benzodiazepines
351 Confidentiality of Protected Health Information – Substance Abuse Treatment Programs 508 Administration of Vivitrol
352 Confidentiality of Protected Health Information – Multi-Disciplinary Teams 509 Controlled Substance Utilization Review System (CURES) and Prescription Drug Monitoring Program (PDMP)
356 PHI Taken to Off-Site Locations 510 Medication Authorization for Dependent Children

511 Psychiatric Mental Health Nurse Practitioner (NP)
407 Cancellation No Show 700 Alcohol and Other Drugs Programs Universal PoliciesChange in Certification Form
408 Protection of Sensitive Records 705 Alcohol and Other Drug Programs – Substance Abuse Prevention and Treatment Block Grant (SAPT)
409 Case Closing 710 Driving Under the Influence (DUI) Programs
416 Medical Records Requirements for Crisis Unit (NMC-ER) Attached 715 Narcotic Treatment Programs
417 Change of Clinician 720 Residential Alcoholism or Drug Abuse Recovery or Treatment Facilities

725 Drug Medi-Cal Substance Use Disorder Services

726 Coordination and Continuity of Care

730 DMC-ODS Residential Authorization


Policy Number
Policy Description
Policy Number
Policy Description
100 Division Policies and Procedures 316 Medical Records ERE Submit
100-B Implementation Plan Update July 2017

102 Organizational Communication Guidelines 323 Coroner’s Office Request for Protected Health Information
103 Program Audits By Outside Agencies 400 Hours Of Clinic Operation
105 Loan of County Equipment 401 Psychological Testing
106 Employee Volunteer Responsible For Supplies And Equipment 402 Dangerous Consumers And Those In Possession Of Weapons
107 Licensure Requirement and Verification of Licensure 404 Behavioral Health Adult Services Authorization For Admission To Napa State Hospital
108 Medicaid Managed Care Plan 405 Behavioral Health Adult Services Authorization For Placement In Locked Skilled Nursing Facilities Or Mental Health Rehabilitation Centers
109 Contract Monitoring 406 Mental Health Adult Services Short Doyle Medi-cal Administrative Days
110 Use Of Medical Transport 410 Committee And Staff meetings
111 Authorization For Short-Doyle Funding For Psychiatric Patients Transferred From Monterey County (Hospitalization And Transportation) 412 Determination Of Appropriate Level Of Care For Public Conservatee Or Voluntary Consumer
112 Treatment Authorization Requests 413 Assessment Of Needs For Placement Of Behavioral Health Adult Services Consumers In Board And Care Facilities
113 Guidelines For Retrospective Claims Review For Inpatient Psychiatric Hospital Services 414 Placement Procedures For Voluntary Consumers
116 Provider Appeal 415 Requests For Interim Assistance Funds
118 Emergency Management System 423 Medical Records Purging
119 Overpayments 445 Fire Evacuation Plan
121 TimeCard Submission Procedure 446 Bomb Threat Procedure
124 Location of New Facilities 448 Transfer Of Clients From Provider To System-Of-Care
125 Medi-Cal Site Certification 450 Persons with Disabilities
126 Posting of Grievance Process Procedure 451 Cultural and Linguistic Services
127 Medicare Billing Control 453 Monterey County Medi-cal Fee For Service Inpatient Procedure At Community Hospital Of The Monterey Peninsula
132 Credentialing And Recredentialing 455 Interface With Physical Health Care For Short Doyle Clients And Excluded Diagnosis Clients
140 Stipends Policy 456 Record Keeping And Filing Of Reportable Incidents As Mandated By Law
141 Health Service Records Retention 458 Service Delivery
142 Excluded Providers 459 Mental Health Linkage
143 Psychologist Waiver and Licensure Requirements 460 Mobile Crisis Services
150 Americans with Disabilities (ADA)

200 Request For Vacation 463 Destruction Of Medical Records With Approved Tar And Paid Ancillary Services For Inpatient Services
205 Granting Exceptions To The Employment Of Spouses Or Relatives 464 Change Of Diagnosis
206 Staff Identification Cards 466 Coordination Of Psychiatric Medication Services Adult Services
302 Legal Liability For Employees Volunteers Actions 467 417_Change_Of_Clinician




Policy Number
Policy Description
Policy Number
Policy Description
117 State Fair Hearing (please see policy MCBH policy 128) 426 Completion of Axis III (Discontinued 1/1/2017)
122 Controlled Substance Prescription Form 442 Family Participation in Service Delivery
303 Medical Record Confidentiality (Discontinued 8/28/2014) 447 Reassessment of Clinical Service Needs
308 Modification Of Original Application For 72 Hour Detention For Evaluation And Treatment Form By Crisis Team 467A Supervisor Electronic Medical Records Review And Annual Update
419 Purchases Of Bus Passes Tickets